Provider Demographics
NPI:1134250871
Name:ENEH, CATHERINE IJEOMA (RN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:IJEOMA
Last Name:ENEH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 TIMBER WAY DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-7774
Mailing Address - Country:US
Mailing Address - Phone:972-822-0829
Mailing Address - Fax:
Practice Address - Street 1:517 TIMBER WAY DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-7774
Practice Address - Country:US
Practice Address - Phone:972-822-0829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX719087163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse