Individual provider · Type 1 NPI
Chinenye Ebele Ezeudemba
Psychiatric/Mental Health Nurse Practitioner · Jacksonville, FL
NPI number
1366010324
Active
Practice location
4600 Touchton Rd E Ste 150
Jacksonville, FL 32246-8299
Mailing address
2040 Carefree Ln
Antioch, TN 37013-3583
Other practice locations
- 2040 Carefree Ln, Antioch, TN 37013-3583 · (615) 420-5634
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 11019685 (FL) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 29479 (TN) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 61589892 (WA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
3 other providers at this address
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About NPI 1366010324
Chinenye Ebele Ezeudemba's National Provider Identifier is 1366010324, issued on Jun 16, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Jacksonville, FL. The record was last updated on Dec 14, 2024.