Provider Demographics
NPI:1841030574
Name:ILODIANYA, UKA ROSE (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:UKA
Middle Name:ROSE
Last Name:ILODIANYA
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 ALMA DR # 105-181
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3482
Mailing Address - Country:US
Mailing Address - Phone:945-253-5657
Mailing Address - Fax:
Practice Address - Street 1:7801 ALMA DR # 105-181
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3482
Practice Address - Country:US
Practice Address - Phone:945-253-5657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1164747363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health