Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Chinenye Ebele Ezeudemba

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1366010324

Chinenye Ebele Ezeudemba is a Psychiatric/Mental Health Nurse Practitioner in Jacksonville, Florida. Works from 2 locations. Licensed in Florida, Tennessee and Washington.

Licensed in
FL, TN, WA
In the registry since
2021
Specialties on file
3
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Practice location Address checks out

4600 Touchton Rd E Ste 150
Jacksonville, FL 32246-8299
Phone: (183) 359-8642
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2040 Carefree Ln, Antioch, TN 37013-3583 — (615) 420-5634

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 61589892 (WA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 11019685 (FL)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 29479 (TN)

Record details

NPI number1366010324
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 16, 2021
Last updated in NPPESDecember 14, 2024
Certification dateDecember 14, 2024
Mailing address2040 Carefree Ln, Antioch, TN 37013-3583

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