Provider Demographics
NPI:1932075991
Name:EBUNILO, KRYSTAL CHIAMAKA (FNP STUDENT)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:CHIAMAKA
Last Name:EBUNILO
Suffix:
Gender:F
Credentials:FNP STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 SIENNA PKWY APT 2305
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1087
Mailing Address - Country:US
Mailing Address - Phone:562-516-8850
Mailing Address - Fax:
Practice Address - Street 1:5330 SIENNA PKWY
Practice Address - Street 2:APT 2305
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459
Practice Address - Country:US
Practice Address - Phone:562-516-8850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program