Healthcare Provider Details

I. General information

NPI: 1558208363
Provider Name (Legal Business Name): PRECIOUS EYEWUMI IZEAGI MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 INTERNATIONAL ST
FAIRBANKS AK
99701-7382
US

IV. Provider business mailing address

8035 E R L THORNTON FWY STE 512
DALLAS TX
75228-7022
US

V. Phone/Fax

Practice location:
  • Phone: 907-328-0581
  • Fax:
Mailing address:
  • Phone: 469-916-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number256683
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1018151
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: