Princess Kukua Ahedor
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · El Paso, TX
NPI 1215401906 · NPPES record last updated Feb 9, 2026
Key facts
- NPI
- 1215401906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- AP139886 (TX)
- Practice address
- 2100 George Dieter Dr
El Paso, TX 79936-3815 - Phone
- (915) 955-2238
- NPI assigned
- Jan 15, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- 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)
Las Cruces, NM 88011
Phone (915) 955-2238
416 N Stanton St
Suite 600D
El Paso, TX 79901-1245
Phone (915) 317-1054
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190222002456 | TX | Practitioner - Nurse Practitioner | 6103165980 | Reassigns benefits to 3 organizations |
| I20260227000117 | NM | Practitioner - Nurse Practitioner | 6103165980 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP139886 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ballem Harmony LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Regional Physician Services of Texas, P.a. | Current |
Accepting new patients | |
| Soul Spring Psychiatry PLLC | Family | Current |
Accepting new patients |
Locations
920 N Telshor Blvd
Ste E
Las Cruces, NM 88011
Phone (575) 521-0900
424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721
4500 Carter Creek Pkwy
Ste 101
Bryan, TX 77802
Phone (210) 367-1530
416 N Stanton St
Ste 600D
El Paso, TX 79901
416 N Stanton St
El Paso, TX 79901
Phone (915) 771-5779
2100 George Dieter Dr
#960213
El Paso, TX 79936
2100 George Dieter Dr
El Paso, TX 79936
Phone (915) 955-2238
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP139886 | TX | Yes |
| Family Nurse Practitioner | 363LF0000X | AP139886 | TX |
Addresses
Primary practice location
2100 George Dieter Dr
El Paso, TX 79936-3815
Mailing address
4500 Carter Creek Pkwy Ste 101B
Bryan, TX 77802-4464
Phone (915) 532-0010
Other practice location 1
920 N Telshor Blvd Ste E
Las Cruces, NM 88011-8279
Phone (915) 955-2238
Other providers in El Paso, TX
- Francisco J Agullo
- Latanya Agurs
- Victoria Agustin
- Julius Fongwe Agwe
- Walter Yaw Agyeman
- Adeel Ahmad
- Kanza Ahmad
- Ali F Ahmed
- Farooque Ahmed
- Koshin Y Ahmed
All providers in El Paso, TX · Psychiatric/Mental Health Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.