Provider Demographics
NPI:1194373977
Name:IBE, JANE ULOMA (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ULOMA
Last Name:IBE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1ELIZABETH PLACE STED
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-1458
Mailing Address - Country:US
Mailing Address - Phone:937-222-2233
Mailing Address - Fax:
Practice Address - Street 1:4018 CLEARSTREAM WAY
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-1458
Practice Address - Country:US
Practice Address - Phone:937-270-1135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily