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General NPI Number Information
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NPI Number | 1588154819
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Entity Type | Individual
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Provider Name | EZINNE IROKU
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Gender | Female
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 9950 W VAN BUREN ST STE 115
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City | AVONDALE
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State | AZ
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Zip | 85323-5318
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Country | US
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Telephone | 623-218-6691
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Fax |
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Provider Business Mailing Address
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Address Line | 16642 W FILLMORE ST
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City | GOODYEAR
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State | AZ
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Zip | 85338-6145
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Country | US
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Telephone | 832-503-4110
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP11672
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License Number State | AZ
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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 | AP11672
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP11672
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License Number State | AZ
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