Provider Demographics
NPI:1790335875
Name:OSUAGWU, UKAMAKA ROSE (RN, PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:UKAMAKA
Middle Name:ROSE
Last Name:OSUAGWU
Suffix:
Gender:F
Credentials:RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N GALLOWAY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-4315
Mailing Address - Country:US
Mailing Address - Phone:214-324-5400
Mailing Address - Fax:972-329-5000
Practice Address - Street 1:303 N GALLOWAY AVE STE A
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-4315
Practice Address - Country:US
Practice Address - Phone:214-324-5400
Practice Address - Fax:972-329-5000
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132169163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5696960Medicaid