Provider Demographics
NPI:1821549411
Name:NWAEME-NGIDI, ISIOMA (FNP)
Entity Type:Individual
Prefix:
First Name:ISIOMA
Middle Name:
Last Name:NWAEME-NGIDI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5126 LILY POND CIR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-0247
Mailing Address - Country:US
Mailing Address - Phone:214-733-7108
Mailing Address - Fax:
Practice Address - Street 1:5126 LILY POND CIR
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-0247
Practice Address - Country:US
Practice Address - Phone:214-733-7108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019388363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily