Provider Demographics
NPI:1013287515
Name:UDEME, IKECHUKWU ANDREW (RN, MBA)
Entity Type:Individual
Prefix:MR
First Name:IKECHUKWU
Middle Name:ANDREW
Last Name:UDEME
Suffix:
Gender:M
Credentials:RN, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 W BEDFORD EULESS RD
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-4006
Mailing Address - Country:US
Mailing Address - Phone:817-268-0041
Mailing Address - Fax:
Practice Address - Street 1:117 W BEDFORD EULESS RD
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-4006
Practice Address - Country:US
Practice Address - Phone:817-268-0041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-31
Last Update Date:2011-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX602249163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health