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Individual

EMMANUEL ETUOKWU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGNP-C, PMHNP-BC

Contact information

Practice address
1300 W TERRELL AVE STE K230, FORT WORTH, TX 76104-2820
(817) 250-4906
Mailing address
1300 W TERRELL AVE STE K230, FORT WORTH, TX 76104-2820

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
731092
TX
363L00000X
Nurse Practitioner
AP139648
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
AP139648
TX
363LG0600X
Gerontology Nurse Practitioner
AP139648
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP139648
TX
363LP2300X
Primary Care Nurse Practitioner
AP139648
TX

Other

Enumeration date
10/23/2018
Last updated
03/02/2023
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