Provider Demographics
NPI:1750038592
Name:OMOREGIE, IRENE O (NP)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:O
Last Name:OMOREGIE
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 1:2323 E 63RD ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64130-3462
Mailing Address - Country:US
Mailing Address - Phone:816-235-8192
Mailing Address - Fax:
Practice Address - Street 1:2323 E 63RD ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64130-3462
Practice Address - Country:US
Practice Address - Phone:816-235-7443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021038362163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health