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Individual
NINA THEKKEKARA
Active
Individual
NINA THEKKEKARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1074738
TX
363LA2100X
Acute Care Nurse Practitioner
1074738
TX
363LG0600X
Gerontology Nurse Practitioner
1074738
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1074738
TX NURSES LICENSE
TX
Enumeration date
08/10/2022
Last updated
07/28/2025
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