EMMANUEL ETUOKWU AGNP-C PMHNP-BC NPI 1154897502

NPI Information

NPI: 1154897502
Provider Name: EMMANUEL ETUOKWU, AGNP-C, PMHNP-BC
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
1300 W TERRELL AVE STE K230
FORT WORTH, TX
ZIP 76104
Phone: (817) 250-4906
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Emmanuel Etuokwu, AGNP-C, PMHNP-BC is an adult health nurse practitioner in Fort Worth, TX with 6 years of experience. Emmanuel Etuokwu, AGNP-C, PMHNP-BC NPI is 1154897502. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1300 W TERRELL AVE STE K230
FORT WORTH, TX
ZIP 76104-820
Phone: (817) 250-4906

The NPI 1154897502 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/23/2018 and was last updated on 3/2/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	AP139648	TEXAS	No
2	363LA2200X	Nurse Practitioner	Adult Health	AP139648	TEXAS	Yes
3	163W00000X	Registered Nurse		731092	TEXAS	No
4	363L00000X	Nurse Practitioner		AP139648	TEXAS	No
5	363LG0600X	Nurse Practitioner	Gerontology	AP139648	TEXAS	No
6	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AP139648	TEXAS	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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