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General NPI Number Information
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NPI Number | 1871184804
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Entity Type | Individual
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Provider Name | IJEOMA NNEKA NWOKE RPH
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Gender | Female
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 5330 S COOPER ST
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City | ARLINGTON
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State | TX
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Zip | 76017-5938
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Country | US
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Telephone | 817-472-9576
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Fax |
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Provider Business Mailing Address
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Address Line | 302 PAINTBRUSH CT
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-3585
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Country | US
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Telephone |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 67820
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License Number State | TX
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