Provider Demographics
NPI:1720642747
Name:NWAWUBA, FAITH OGECHUKWU (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:OGECHUKWU
Last Name:NWAWUBA
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:MRS
Other - First Name:FAITH
Other - Middle Name:OGECHUKWU
Other - Last Name:EKWUEME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1200
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-1200
Mailing Address - Country:US
Mailing Address - Phone:722-033-6009
Mailing Address - Fax:972-203-3601
Practice Address - Street 1:2895 LEWIS LN
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-9331
Practice Address - Country:US
Practice Address - Phone:972-203-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140940363LG0600X, 363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP140940OtherTEXAS BOARD OF NURSING