Provider Demographics
NPI:1720300072
Name:CHUKWUKA, CHINYERE E (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CHINYERE
Middle Name:E
Last Name:CHUKWUKA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6118 TERRELL HILLS DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-6121
Mailing Address - Country:US
Mailing Address - Phone:713-252-6780
Mailing Address - Fax:281-232-8311
Practice Address - Street 1:6118 TERRELL HILLS DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-6121
Practice Address - Country:US
Practice Address - Phone:713-252-6780
Practice Address - Fax:281-232-8311
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010642251E00000X
TX1098260363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747177Medicare PIN