Active NPI
Lighthearted Care and Wellness LLC
- Family Nurse Practitioner
- Manvel, TX
National Provider Identifier
1750197307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- LIGHTHEARTED CARE AND WELLNESS LLC
- Practice address
- 23 San Simeon Dr
Manvel, TX 77578-3286 - Phone
- (337) 532-1615
- NPI assigned
- Dec 9, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Obiageli Durousseau
- Title
- FNP- BC
- Phone
- (337) 532-1615
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
23 San Simeon Dr
Manvel, TX 77578-3286
Mailing address
23 San Simeon Dr
Manvel, TX 77578-3286
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733702400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1733702400000",
"number": "1750197307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 SAN SIMEON DR",
"city": "MANVEL",
"state": "TX",
"postal_code": "775783286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 SAN SIMEON DR",
"city": "MANVEL",
"state": "TX",
"postal_code": "775783286",
"telephone_number": "337-532-1615"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIGHTHEARTED CARE AND WELLNESS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-12-09",
"last_updated": "2024-12-09",
"certification_date": "2024-12-09",
"status": "A",
"authorized_official_last_name": "DUROUSSEAU",
"authorized_official_first_name": "OBIAGELI",
"authorized_official_title_or_position": "FNP- BC",
"authorized_official_telephone_number": "337-532-1615"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Manvel, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.