Provider Demographics
NPI:1699031609
Name:MADUKA, STELLA NDIDI (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:NDIDI
Last Name:MADUKA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2018 RUSTIC OAK LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-5651
Mailing Address - Country:US
Mailing Address - Phone:832-766-2270
Mailing Address - Fax:281-232-7422
Practice Address - Street 1:2018 RUSTIC OAK LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-5651
Practice Address - Country:US
Practice Address - Phone:832-766-2270
Practice Address - Fax:128-123-2742
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX723609363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily