Provider Demographics
NPI:1225348873
Name:MENKITI, IJEOMA (NP)
Entity Type:Individual
Prefix:MRS
First Name:IJEOMA
Middle Name:
Last Name:MENKITI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 8TH ST
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-3347
Mailing Address - Country:US
Mailing Address - Phone:888-985-2727
Mailing Address - Fax:609-567-8832
Practice Address - Street 1:2 8TH ST
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-3347
Practice Address - Country:US
Practice Address - Phone:888-985-2727
Practice Address - Fax:609-567-8832
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00305900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health