MEDICARE: NGOZI A IHEGBE RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	RN57879	DC

General Provider Information

NPI Number	:	1538319553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGOZI A IHEGBE RN

Provider Business Mailing Address
First Line	:	3861 ALABAMA AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-1001
Country	:	US
Telephone Number	:	202-645-3832
Fax Number	:

Provider Business Practice Location Address
First Line	:	3861 ALABAMA AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-1001
Country	:	US
Telephone Number	:	202-645-3832
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2008
Last Update Date	:	09/26/2008

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