Individual provider · Type 1 NPI
Krystal Ukaegbu, RN, MSN
Mental Illness Community Based Residential Treatment Facility · Shreveport, LA
NPI number
1710787197
Active
Practice location
7000 Fern Ave Apt 135
Shreveport, LA 71105-4914
Mailing address
8880 Bernay Dr
Shreveport, LA 71118-2024
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | RN131251 (LA) |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | None listed |
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | None listed |
Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
About NPI 1710787197
Krystal Ukaegbu, RN, MSN's National Provider Identifier is 1710787197, issued on Mar 15, 2025. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Shreveport, LA. The record was last updated on Jul 9, 2025.