Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP140111 | TX |
N | 363LP2300X | Nurse Practitioner - Primary Care | AP140111 | TX |
NPI | 1003472473 |
---|---|
Provider Name | Nonye Uchechi Nelson |
First Address | Katy, TX 77450-5519 |
Second Address | Houston, TX 77094-1291 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2019 |
Last Update Date | 11/05/2019 |