Princess Kukua Ahedor

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP139886 Issued in TX

Practice address

416 N Stanton St Ste 600D
El Paso, TX 79901-1245

Phone

(915) 317-1054

Fax

(982) 268-0069

NPI assigned

Jan 15, 2019

Last updated

Sep 15, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, NM2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Soul Spring Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • El Paso, TX
  • NPI 1902616907

  Family, NM

  Medicare reassignment NPD Authorized official
• Ballem Harmony LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bryan, TX
  • NPI 1124844469
  Medicare reassignment NPD
• Regional Physician Services of Texas, P.a.

  • Nurse Practitioner
  • Abilene, TX
  • NPI 1043529944
  Medicare reassignment NPD

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1215401906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 TIERRA MURCIA ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799382220",
            "telephone_number": "915-317-1054",
            "fax_number": "982-268-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N STANTON ST STE 600D",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799011245",
            "telephone_number": "915-317-1054",
            "fax_number": "982-268-0069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 N Telshor Blvd Ste E",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880118279",
            "country_code": "US",
            "telephone_number": "915-955-2238",
            "fax_number": "982-268-0069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHEDOR",
        "first_name": "PRINCESS",
        "middle_name": "KUKUA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-15",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139886",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP139886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francisco J Agullo, MD
• Latanya Agurs, M.D.
• Victoria Agustin
• Julius Fongwe Agwe, PHARM.D
• Walter Yaw Agyeman, MD
• Adeel Ahmad, MD
• Kanza Ahmad, MD
• Ali F Ahmed, MD
• Farooque Ahmed, MD
• Koshin Y Ahmed

• Psychiatric/Mental Health Nurse Practitioner in El Paso, TX
• Providers in El Paso, 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 Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.