Provider Demographics
NPI:1861884009
Name:NWANGUMA, AKARAKA DESTINY (RN)
Entity type:Individual
Prefix:
First Name:AKARAKA
Middle Name:DESTINY
Last Name:NWANGUMA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AKARAKA
Other - Middle Name:DESTINY
Other - Last Name:ONYEJU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9319 LBJ FWY STE 115
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3440
Mailing Address - Country:US
Mailing Address - Phone:826-704-9732
Mailing Address - Fax:
Practice Address - Street 1:9319 LBJ FWY STE 115
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3440
Practice Address - Country:US
Practice Address - Phone:826-704-9732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-25
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
TX841733163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171M00000XOther Service ProvidersCase Manager/Care Coordinator