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General NPI Number Information
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NPI Number | 1528358850
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Entity Type | Individual
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Provider Name | IJEOMA GERTRUDE NWANEBU III APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 04/07/2011
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Last Update Date | 11/27/2025
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Provider Practice Location Address
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Address Line | 1000 N LINCOLN BLVD STE 3400
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-3252
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Country | US
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Telephone | 405-271-1000
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Fax | 405-271-7014
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Provider Business Mailing Address
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Address Line | 700 NE 13TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5004
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Country | US
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Telephone | 405-271-5656
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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 | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | R0081415
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 81415
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License Number State | OK
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