Provider Demographics
NPI:1093446783
Name:NWANORUE, IJEOMA GLADYS (RN)
Entity Type:Individual
Prefix:
First Name:IJEOMA
Middle Name:GLADYS
Last Name:NWANORUE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 SUMMIT AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-4339
Mailing Address - Country:US
Mailing Address - Phone:540-514-3824
Mailing Address - Fax:
Practice Address - Street 1:6412 RICHWOOD TRL
Practice Address - Street 2:
Practice Address - City:MOSELEY
Practice Address - State:VA
Practice Address - Zip Code:23120-1834
Practice Address - Country:US
Practice Address - Phone:540-514-3824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001284892163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health