Provider Demographics
NPI:1639639941
Name:AMAEFULE, JOVITA ONYINYECHI
Entity Type:Individual
Prefix:MRS
First Name:JOVITA
Middle Name:ONYINYECHI
Last Name:AMAEFULE
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 1:7808 CARDINAL CT
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-6201
Mailing Address - Country:US
Mailing Address - Phone:682-248-1706
Mailing Address - Fax:
Practice Address - Street 1:7808 CARDINAL CT
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6201
Practice Address - Country:US
Practice Address - Phone:682-248-1706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX959112163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX959112OtherTEXAS BOARD OF NURSING