Alisa Subulwa Chikosha

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1094934 Issued in TX

Practice address

1527 W State Highway 114
Grapevine, TX 76051-8646

Phone

(817) 721-6893

NPI assigned

Mar 14, 2023

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679184000000",
    "number": "1790486942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 W STATE HIGHWAY 114",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 W STATE HIGHWAY 114",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518646",
            "telephone_number": "817-721-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIKOSHA",
        "first_name": "ALISA",
        "middle_name": "SUBULWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-19",
        "certification_date": "2023-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1094934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.