VANESSA MUKASOLU ECHETABU (NPI# 1447895289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447895289 |
| Entity Type | Individual |
| Full Name | VANESSA MUKASOLU ECHETABU |
| Credential | PMHNP-BC |
| Practice Address |
6363 Forest Park Rd Fl 7 Dallas TX 75235-5479 |
| Mailing Address |
Po Box 845347 Dallas TX 75284-5347 |
| Practice Telephone | 2146458500 |
| Practice Fax Number | 2146483775 |
| Mailing Telephone | 2146450624 |
| Mailing Fax Number | 2146450078 |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2019-11-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP143630 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6363 FOREST PARK RD FL 7 |
| City | DALLAS |
| State | TX |
| Zip Code | 75235-5479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992943658 | Venkata Marthanda Sastry Mukkavilli | Psychiatry & Neurology | 6363 Forest Park Rd Fl 7, Suite 749, Dallas, TX 75235-5479 | 2009-02-03 |
| 1700421385 | Christopher Robert Glowacki | Psychologist | 6363 Forest Park Rd Fl 7, Dallas, TX 75235-5479 | 2019-11-07 |
| 1699291666 | Adriana Sum Miu | Psychologist | 6363 Forest Park Rd Fl 7, Dallas, TX 75235-5479 | 2017-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265058895 | Kailey Elaine Flowers | Physical Therapy Assistant | 2400 Empire Central Drive, Suite B, Dallas, TX 75235 | 2020-06-19 |
| 1265061071 | Bella Xinyi O'malley | Student in an Organized Health Care Education/Training Program | 1935 Medical Drive, Dallas, TX 75235 | 2020-04-03 |
| 1427687318 | Can Ozlu | Student in an Organized Health Care Education/Training Program | Children's Medical Center of Dallas, 1935 Medical Distr, Dallas, TX 75235 | 2020-04-03 |
| 1689137515 | Tarek Mansi | Student in an Organized Health Care Education/Training Program | 2222 Medical District Dr Apt 4325, Dallas, TX 75235 | 2019-04-08 |
| 1386117125 | Christine Elizabeth Smith | Physician Assistant | 8134 Tex Oak Avenue, Dallas, TX 75235 | 2019-01-04 |
| 1447720016 | Michelle Angelina Dye | Physician Assistant | 5959 Maple Avenue Apt 1171, Dallas, TX 75235 | 2018-11-27 |
| 1255869335 | Andrea Nicole Pennington-peace | Specialist/Technologist, Other | 1935 Medial District, Dallas, TX 75235 | 2017-06-01 |
| 1194258152 | Tricia Rood | Student in an Organized Health Care Education/Training Program | 5200 Harry Hines Blvd., Dallas, TX 75235 | 2017-04-06 |
| 1437690971 | Robin Lee | Counselor | 8915 Hrry Hines Blvd, Dallas, TX 75235 | 2017-03-16 |
| 1871033746 | Javier Davila-lopez | Counselor | 1545 Mockingbird Lane, Suite 4000, Dallas, TX 75235 | 2017-02-27 |
| Find all providers in zip 75235 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366052805 | Deadra Jordan | Nurse Practitioner | 5995 Summerside Dr Unit 795142, Dallas, TX 75379-0095 | 2020-08-07 |
| 1083235691 | Annemarie Osondu Odo | Nurse Practitioner | 9450 Skillman St Ste 120, Dallas, TX 75243-8235 | 2020-05-05 |
| 1740811934 | Kellie Lynn Westmoreland | Nurse Practitioner | 7777 Forest Ln Ste 833, Dallas, TX 75230-2571 | 2020-01-28 |
| 1346871696 | Ebote Ngite Nnoko | Nurse Practitioner | 108 Crescent Woode Dr, Dallas, GA 30157-5725 | 2020-01-27 |
| 1689238461 | Ican Medics and Psych Services Pllc | Nurse Practitioner | 9535 Forest Ln Ste 109, Dallas, TX 75243-5934 | 2019-04-26 |
| 1942773643 | Jo Kutty Kurian | Nurse Practitioner | 6363, Forest Park Road, 7th Floor, Suite 749, Dallas, TX 75390-9121 | 2019-01-04 |
| 1528538170 | Angel Laamber Adams | Nurse Practitioner | 7777 Forest Lane Suite C 833, Dallas, TX 75230 | 2018-11-27 |
| 1114495983 | Nwamaka Ngumezi | Nurse Practitioner | 3417 Gaston Ave Ste 815, Dallas, TX 75246-2034 | 2018-11-08 |
| 1811406150 | Justin Neal Mehan | Nurse Practitioner | 712 N Washington Ave Ste 411, Dallas, TX 75246-1626 | 2017-09-28 |
| 1114321775 | Shane Tipton | Nurse Practitioner | 6363 Forest Park Road 7th Floor Ste 749, Dallas, TX 75390-4426 | 2014-10-10 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.