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General NPI Number Information
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NPI Number | 1275957771
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Entity Type | Individual
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Provider Name | FELICIA C IKEBUDE
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Gender | Female
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Dates
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Enumeration Date | 02/05/2014
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 701 PARK AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55415-1623
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Country | US
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Telephone | 612-873-2232
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Fax |
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Provider Business Mailing Address
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Address Line | 5712 162ND LN NW
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City | RAMSEY
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State | MN
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Zip | 55303-3980
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Country | US
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Telephone | 612-267-0424
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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 | 2022
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R-155858-0
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License Number State | MN
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