Provider Demographics
NPI:1013453711
Name:ENEREMADU, CASSANDRA CHIDIMMA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:CHIDIMMA
Last Name:ENEREMADU
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CHIDIMMA
Other - Middle Name:AMARACHI
Other - Last Name:ENEREMADU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3030 JOE BATTLE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2668
Mailing Address - Country:US
Mailing Address - Phone:915-225-4470
Mailing Address - Fax:915-533-8055
Practice Address - Street 1:1463 S MASON RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-4568
Practice Address - Country:US
Practice Address - Phone:305-266-2929
Practice Address - Fax:915-533-8055
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily