Individual
ADAEZE BIANCA IDAKWO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4930 MOUNTAIN MAPLE TRL, ROSENBERG, TX 77471-1560
(832) 430-0642
Mailing address
4930 MOUNTAIN MAPLE TRL, ROSENBERG, TX 77471-1560
(832) 430-0642
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
970266
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1180787
TX
363LP1700X
Perinatal Nurse Practitioner
1180787
TX
Other
Enumeration date
10/29/2024
Last updated
05/09/2026
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