Provider Demographics
NPI:1649540758
Name:OMO-OZUGO, CHANUVETTE (RN)
Entity type:Individual
Prefix:MRS
First Name:CHANUVETTE
Middle Name:
Last Name:OMO-OZUGO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:CHANUVETTE
Other - Middle Name:WILLIAMS
Other - Last Name:SPIKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5318 ELDERBERRY ARBOR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3389
Mailing Address - Country:US
Mailing Address - Phone:832-805-3313
Mailing Address - Fax:
Practice Address - Street 1:17350 STATE HWY 249
Practice Address - Street 2:STE 220 7927
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-3389
Practice Address - Country:US
Practice Address - Phone:832-805-3313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX718152163WH0200X, 163WX1500X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care