Provider Demographics
NPI:1740211531
Name:UKAH, FIDELIA IJEURU (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:FIDELIA
Middle Name:IJEURU
Last Name:UKAH
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12810 CANDACE CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3957
Mailing Address - Country:US
Mailing Address - Phone:281-261-0288
Mailing Address - Fax:
Practice Address - Street 1:19900 HWY. 59
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:281-341-8330
Practice Address - Fax:713-358-4805
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX580397363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8X3689OtherBCBS