Healthcare Provider Details

I. General information

NPI: 1477466431
Provider Name (Legal Business Name): IFEATU NATASHA NWOBU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 E MAPLE ST
NORTH CANTON OH
44720-3336
US

IV. Provider business mailing address

2323 PLAZA BLVD APT 472
RICHARDSON TX
75082-4162
US

V. Phone/Fax

Practice location:
  • Phone: 330-490-7090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: