Provider Demographics
NPI:1639763774
Name:LEKWUWA, CHRISTIANA IJEOMA
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIANA
Middle Name:IJEOMA
Last Name:LEKWUWA
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 1:3514 KNIGHT DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-2857
Mailing Address - Country:US
Mailing Address - Phone:214-235-1687
Mailing Address - Fax:
Practice Address - Street 1:3514 KNIGHT DR
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-2857
Practice Address - Country:US
Practice Address - Phone:214-235-1687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX692428363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health