Provider Demographics
NPI:1629592548
Name:AKAHARA, IFEYINWA (LVN)
Entity Type:Individual
Prefix:
First Name:IFEYINWA
Middle Name:
Last Name:AKAHARA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:IFEYINWA
Other - Middle Name:
Other - Last Name:AKAHARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2840 SHADOWBRIAR DR APT 1207
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3288
Mailing Address - Country:US
Mailing Address - Phone:816-682-2327
Mailing Address - Fax:
Practice Address - Street 1:2840 SHADOWBRIAR DR APT 1207
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-3288
Practice Address - Country:US
Practice Address - Phone:816-682-2327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX815064754Medicaid