Provider Demographics
NPI:1013148766
Name:UMEZURIKE, NGOZI LYNDA (RN BSN)
Entity Type:Individual
Prefix:
First Name:NGOZI
Middle Name:LYNDA
Last Name:UMEZURIKE
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 9TH AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3932
Mailing Address - Country:US
Mailing Address - Phone:817-834-8500
Mailing Address - Fax:469-713-8870
Practice Address - Street 1:900 8TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3902
Practice Address - Country:US
Practice Address - Phone:817-834-8500
Practice Address - Fax:469-713-8870
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136375363L00000X
TX738762163WC0200X, 163WC0400X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WC0400XNursing Service ProvidersRegistered NurseCase Management