Provider Demographics
NPI:1801403076
Name:JHA, IRYNA VASILIJ (APRN)
Entity Type:Individual
Prefix:MRS
First Name:IRYNA
Middle Name:VASILIJ
Last Name:JHA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:IRYNA
Other - Middle Name:VASILIJ
Other - Last Name:BAUMGARTL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:YAKHNIN
Mailing Address - Street 1:8212 OVATION DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2644
Mailing Address - Country:US
Mailing Address - Phone:919-428-1261
Mailing Address - Fax:
Practice Address - Street 1:8212 OVATION DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2644
Practice Address - Country:US
Practice Address - Phone:919-428-1261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2021-09-17
Deactivation Date:2021-03-30
Deactivation Code:
Reactivation Date:2021-07-22
Provider Licenses
StateLicense IDTaxonomies
NV831986363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily