Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1018699 | TX |
NPI | 1003481961 |
---|---|
Provider Name | Bridget Ugonna Onyegesi |
First Address | Bryan, TX 77802-5361 |
Second Address | Bryan, TX 77802-2544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2021 |
Last Update Date | 24/05/2021 |