Most Relevant Information
Provider Data
| NPI Number: | 1003496472 |
| Provider Name: | IJEGO NWANKWO PMHNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 1033715 |
Most Important Dates
| Enumeration Date: | 04/10/2021 |
| Last Updated: | 05/04/2021 |
Provider Practice Location
1601 ELM ST STE 4360
DALLAS
TX
752014701
Practice Location Phone/Fax
| Phone: | 4154032156 |
| Fax: |
Provider Mailing Location
PO BOX 850363
RICHARDSON
TX
750850363
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |