Provider Demographics
NPI:1245462084
Name:NWEKE, KACHI NKONYEK (NP)
Entity type:Individual
Prefix:MS
First Name:KACHI
Middle Name:NKONYEK
Last Name:NWEKE
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:153 STEVENS AVENUE
Mailing Address - Street 2:#4
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2543
Mailing Address - Country:US
Mailing Address - Phone:914-668-8080
Mailing Address - Fax:914-668-2540
Practice Address - Street 1:153 STEVENS AVENUE
Practice Address - Street 2:#4
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2543
Practice Address - Country:US
Practice Address - Phone:914-668-8080
Practice Address - Fax:914-668-2540
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF335645363LF0000X
NYF335645-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily