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

Keyna Omenukor

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1215307715

Keyna Omenukor is a Nurse Practitioner in Mesquite, Texas. Qualified in 2018, 8 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Texas, Virginia and Washington.

Years since qualifying
8
Licensed in
TX, VA, WA
In the registry since
2015
Specialties on file
4
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Practice location Address checks out

1675 Republic Pkwy Ste 190
Mesquite, TX 75150-6902
Phone: (972) 576-7399
Fax: (972) 476-0006
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence AP128934 (TX)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 0024286045 (VA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence AP61500520 (WA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence AP128934 (TX)

Record details

NPI number1215307715
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 28, 2015
Last updated in NPPESOctober 2, 2024
Certification dateSeptember 24, 2024
Mailing address1675 Republic Pkwy Ste 190, Mesquite, TX 75150-6902

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Mesquite