Etido J Udosen, PMHNP-BC, CNP, MSN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1021337 Issued in TX

Practice address

6160 Warren Pkwy Ste 100
Frisco, TX 75034-9415

Phone

(197) 256-5397

NPI assigned

Dec 13, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Science - Nursing

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675555200000",
    "number": "1083200208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 WARREN PKWY STE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349415",
            "telephone_number": "972-565-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 WARREN PKWY STE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349415",
            "telephone_number": "197-256-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDOSEN",
        "first_name": "ETIDO",
        "middle_name": "J",
        "credential": "PMHNP-BC, CNP, MSN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-13",
        "last_updated": "2023-02-05",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1021337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlene Tyars, LVN
• John C Tyler
• U S Anesthesia Partners of Texas, PA
• Nchebechukwu Udeogu
• Abasiubong Udoka, APRN
• Uchenna Stephanie Ukoha, DNP, APRN
• Robert Frank Ulrich, D.O.
• Ultima Medical Supply LLC
• Ultra Care Medical
• Daniel Um, MD

• Psychiatric/Mental Health Nurse Practitioner in Frisco, TX
• Providers in Frisco, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.