Provider Demographics
NPI:1356906457
Name:EKWURU, CHUKWUEMEKA N (RN)
Entity type:Individual
Prefix:
First Name:CHUKWUEMEKA
Middle Name:N
Last Name:EKWURU
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:EMEKA
Other - Middle Name:
Other - Last Name:EKWURU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:915 HIGHLAND POINTE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5421
Mailing Address - Country:US
Mailing Address - Phone:916-903-7778
Mailing Address - Fax:916-459-4380
Practice Address - Street 1:4112 CRESTLINE AVE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7103
Practice Address - Country:US
Practice Address - Phone:916-903-7778
Practice Address - Fax:916-459-4380
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA803858163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse