Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP10393 | AZ |
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP10393 | AZ |
NPI | 1073038824 |
---|---|
Provider Name | Dr. Dorothy Chinyere Igwe |
First Address | Gilbert, AZ 85296-7365 |
Second Address | Phoenix, AZ 85044-9102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2017 |
Last Update Date | 01/10/2021 |