Provider Demographics
NPI:1043057417
Name:OSAJI, KENECHI E (PMHNP)
Entity type:Individual
Prefix:
First Name:KENECHI
Middle Name:E
Last Name:OSAJI
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15015 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7081
Mailing Address - Country:US
Mailing Address - Phone:281-961-7668
Mailing Address - Fax:
Practice Address - Street 1:15015 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7081
Practice Address - Country:US
Practice Address - Phone:832-879-5923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX806404163W00000X
TX1157376363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse