Provider Demographics
NPI:1164527008
Name:IWU, DOMITILLA AKUFORO (NP)
Entity Type:Individual
Prefix:MRS
First Name:DOMITILLA
Middle Name:AKUFORO
Last Name:IWU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1058 MOCKINGBIRD HILL CT
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-3255
Mailing Address - Country:US
Mailing Address - Phone:972-424-1691
Mailing Address - Fax:972-424-1691
Practice Address - Street 1:1058 MOCKINGBIRD HILL CT
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-3255
Practice Address - Country:US
Practice Address - Phone:972-424-1691
Practice Address - Fax:972-424-1691
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX683861163WH0200X, 363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner