Provider Demographics
NPI:1609357219
Name:CHUKWUKERE, CHINWENDU MARY
Entity Type:Individual
Prefix:
First Name:CHINWENDU
Middle Name:MARY
Last Name:CHUKWUKERE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 ADDICKS CLODINE RD APT 1206
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-3085
Mailing Address - Country:US
Mailing Address - Phone:806-690-2448
Mailing Address - Fax:
Practice Address - Street 1:3443 ADDICKS CLODINE RD APT 1206
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-3085
Practice Address - Country:US
Practice Address - Phone:806-690-2448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX900456163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health