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General NPI Number Information
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NPI Number | 1184824633
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Entity Type | Individual
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Provider Name | IJEOMA NNEKA INNOCENT-ITUAH MD
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Gender | Female
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 05/05/2017
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Provider Practice Location Address
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Address Line | 180 W ESPLANADE AVE
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City | KENNER
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State | LA
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Zip | 70065-2467
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Country | US
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Telephone | 504-468-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 1514 JEFFERSON HIGHWAY
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City | NEW ORLEANS
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State | LA
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Zip | 70121
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Country | US
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Telephone | 504-842-4000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 674-L
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.203042
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License Number State | LA
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