Provider Demographics
NPI:1750628020
Name:ODIM-ELUEBO, CATHRINE OWIYE (NP)
Entity Type:Individual
Prefix:MS
First Name:CATHRINE
Middle Name:OWIYE
Last Name:ODIM-ELUEBO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7540 SILVERBROOK LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4471
Mailing Address - Country:US
Mailing Address - Phone:469-826-6647
Mailing Address - Fax:214-217-2007
Practice Address - Street 1:7540 SILVERBROOK LN
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4471
Practice Address - Country:US
Practice Address - Phone:469-826-6647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX775242163WH0200X
TXAP141196363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX775242OtherRN
TXAP141196OtherPSYCHIATRIC/MENTAL HEALTH NURSE PRACTITIONER