Edoghogho Stacy Edosonmwan, RN in Waxahachie, TX

Edoghogho Stacy Edosonmwan, RN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Waxahachie, Texas. Her current practice location is 201 Amanda Ln Ste 100, Waxahachie, Texas. You can reach out to her office (for appointments etc.) via phone at (469) 523-2646.

Edoghogho Stacy Edosonmwan is licensed to practice in Texas (license number 1116542) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1356808901.

Contact Information

	Edoghogho Stacy Edosonmwan, RN
	201 Amanda Ln Ste 100, Waxahachie, TX 75165-1391
	(469) 523-2646
	(469) 242-9599

Map and Direction

Provider's Profile

Full Name	Edoghogho Stacy Edosonmwan
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	201 Amanda Ln Ste 100, Waxahachie, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1356808901
Provider Enumeration Date: 03/01/2019
Last Update Date: 05/19/2025

Medicare PECOS Information:

PECOS PAC ID: 7911449590
Enrollment ID: I20240611001982

Medical Identifiers

Medical identifiers for Edoghogho Stacy Edosonmwan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1356808901	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	951996 (Texas)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	230297 (Louisiana)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	1116542 (Texas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Edoghogho Stacy Edosonmwan allows following entities to bill medicare on her behalf.

Entity Name	Swla Center For Health Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720014186 PECOS PAC ID: 9133029853 Enrollment ID: O20040109000902

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Edoghogho Stacy Edosonmwan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Edoghogho Stacy Edosonmwan, RN 2000 Opelousas St, Lake Charles, LA 70601-2641 Ph: (337) 769-9451	Edoghogho Stacy Edosonmwan, RN 201 Amanda Ln Ste 100, Waxahachie, TX 75165-1391 Ph: (469) 523-2646

Reviews and Comments

Nurse Practitioner Nurses in Waxahachie, TX

Antoinette Marie Mccauley, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 840 Dove Meadow Trl, Waxahachie, TX 75167 Phone: 318-349-2583
Madhuri Shukla, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 172 Sapphire Ln, Waxahachie, TX 75165 Phone: 214-923-4424
Briana Delgado-garcia, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 141 Rvg Pkwy Ste 101, Waxahachie, TX 75165 Phone: 972-923-8923 Fax: 877-399-8499
Kylie Nichole Steen, APRN-CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1710 W Hwy 287 Bus Ste 100, Waxahachie, TX 75165 Phone: 972-937-7878 Fax: 972-937-8934
Obioma Anyogu, APRN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 201 Ferris Ave Ste I, Waxahachie, TX 75165 Phone: 972-937-1613 Fax: 972-937-0891
Mrs. Gisela Taylor Nelson, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 201 Amanda Ln, Suite 200, Waxahachie, TX 75165 Phone: 972-937-1300 Fax: 972-937-1389
Adeel Siddiqui, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 201 Amanda Ln Ste 300, Waxahachie, TX 75165 Phone: 469-638-6050

Edoghogho Stacy Edosonmwan, RN - Medicare Nurse Practitioner in Waxahachie, TX