Provider Demographics
NPI:1972091684
Name:ORIEUKWU, MIRIAM (FNP)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:ORIEUKWU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:
Other - Last Name:MBAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2943 DAWN HAVEN LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4062
Mailing Address - Country:US
Mailing Address - Phone:713-231-7819
Mailing Address - Fax:
Practice Address - Street 1:2943 DAWN HAVEN LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4062
Practice Address - Country:US
Practice Address - Phone:713-231-7819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133331363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily