Provider Demographics
NPI:1750048476
Name:ENEREMADU, CHISOM CHIWENDU (FNP)
Entity Type:Individual
Prefix:MS
First Name:CHISOM
Middle Name:CHIWENDU
Last Name:ENEREMADU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58538
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8538
Mailing Address - Country:US
Mailing Address - Phone:281-985-5984
Mailing Address - Fax:281-372-2151
Practice Address - Street 1:600 N KOBAYASHI STE 311
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4841
Practice Address - Country:US
Practice Address - Phone:281-985-5984
Practice Address - Fax:281-372-2151
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1141017363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily