Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP138509 | TX |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP138509 | TX |
N | 363LP0200X | Nurse Practitioner - Pediatrics | AP138509 | TX |
N | 363LW0102X | Nurse Practitioner - Women's Health | AP138509 | TX |
NPI | 1053892240 |
---|---|
Provider Name | Loise U Ekwem |
First Address | Sugar Land, TX 77498-1055 |
Second Address | Sugar Land, TX 77498-1055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2018 |
Last Update Date | 24/08/2018 |