Provider Demographics
NPI:1548913080
Name:TOURACKEMLLC
Entity type:Organization
Organization Name:TOURACKEMLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER NP
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:NDUKA-ONWUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-777-1493
Mailing Address - Street 1:221 SKYLINE DR STE 271
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-1352
Mailing Address - Country:US
Mailing Address - Phone:908-777-1493
Mailing Address - Fax:
Practice Address - Street 1:221 SKYLINE DR STE 271
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-1352
Practice Address - Country:US
Practice Address - Phone:908-777-1493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty