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General NPI Number Information
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NPI Number | 1275174807
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Entity Type | Individual
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Provider Name | CHIOMA E ILOABACHIE NP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2019
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 4411 BEN FRANKLIN BLVD
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City | DURHAM
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State | NC
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Zip | 27704-2147
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Country | US
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Telephone | 919-471-5474
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Fax |
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Provider Business Mailing Address
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Address Line | 4705 DRESDEN VILLAGE DR
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City | RALEIGH
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State | NC
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Zip | 27604-4983
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Country | US
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Telephone | 919-749-2693
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2025004842
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AG04190024
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License Number State | NC
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