Provider Demographics
NPI:1780259697
Name:EKEH, EKEOMA (RN, NP)
Entity type:Individual
Prefix:
First Name:EKEOMA
Middle Name:
Last Name:EKEH
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 TUCKER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-2314
Mailing Address - Country:US
Mailing Address - Phone:832-567-8198
Mailing Address - Fax:
Practice Address - Street 1:2411 TUCKER CREEK DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-2314
Practice Address - Country:US
Practice Address - Phone:832-567-8198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF10201224363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily