Ms. Wanda Ikeda
Nurse Practitioner - Acute Care
499 Gloster Creek Vlg Ste A2
Tupelo
, Mississippi 38801-4749
Ms. Wanda Ikeda
Nurse Practitioner - Acute Care
499 Gloster Creek Vlg Ste A2
Tupelo
, Mississippi 38801-4749
(662) 377-2403
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About
Features
Specialties
- Nurse Practitioner - Acute Care
Languages spoken
- English
Location
First Address
- Ms. Wanda Ikeda
- Po Box 3488
- Tupelo, MS
- Zip : 38803-3488
- Fax : (662) 377-2403
- Phone : (662) 377-2949
Second Address
- Ms. Wanda Ikeda
- 499 Gloster Creek Vlg Ste A2
- Tupelo, MS
- Zip : 38801-4749
- Fax : (662) 377-2403
- Phone : (662) 620-6800
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LA2100X | Nurse Practitioner - Acute Care | R696196 | MS |
National Provider Identifier
| NPI | 1013114677 |
|---|---|
| Provider Name | Ms. Wanda Ikeda |
| First Address | Tupelo, MS 38803-3488 |
| Second Address | Tupelo, MS 38801-4749 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/06/2007 |
| Last Update Date | 17/03/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.