Provider Demographics
NPI:1902404940
Name:UKPU, MAUREEN (FNP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:UKPU
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 1:30734 ASTER BROOK DR
Mailing Address - Street 2:
Mailing Address - City:BROOKSHIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77423-0147
Mailing Address - Country:US
Mailing Address - Phone:901-859-0411
Mailing Address - Fax:
Practice Address - Street 1:30734 ASTER BROOK DR
Practice Address - Street 2:
Practice Address - City:BROOKSHIRE
Practice Address - State:TX
Practice Address - Zip Code:77423-0147
Practice Address - Country:US
Practice Address - Phone:901-859-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1015579363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily