Provider Demographics
NPI:1659941169
Name:NNABUENYI, CHINYELU JUDITH PHILIPPA
Entity Type:Individual
Prefix:
First Name:CHINYELU
Middle Name:JUDITH PHILIPPA
Last Name:NNABUENYI
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 1:1010 SAN JACINTO DR APT 633
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-8233
Mailing Address - Country:US
Mailing Address - Phone:701-721-5015
Mailing Address - Fax:
Practice Address - Street 1:1010 SAN JACINTO DR APT 633
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-8233
Practice Address - Country:US
Practice Address - Phone:701-721-5015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX895783163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse