Healthcare Provider Details

I. General information

NPI: 1134025745
Provider Name (Legal Business Name): IJEOMA ANYAOGU IWEAJUNWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2026
Last Update Date: 10/19/2026
Certification Date: 10/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MARYVILLE UNIVERSITY CATHERINE MCAULEY SCHOOL OF NURSING
ST. LOUIS MO
63141
US

IV. Provider business mailing address

1008 BLUE JUNIPER CIR
LOGANVILLE GA
30052-5991
US

V. Phone/Fax

Practice location:
  • Phone: 314-529-6750
  • Fax:
Mailing address:
  • Phone: 470-774-6778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number30045
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: