Provider Demographics
NPI:1013492958
Name:ELEBO, IFEOMA NKEMDILIM JENNIFER (DNP)
Entity type:Individual
Prefix:MRS
First Name:IFEOMA
Middle Name:NKEMDILIM JENNIFER
Last Name:ELEBO
Suffix:
Gender:
Credentials:DNP
Other - Prefix:MS
Other - First Name:IFEOMA
Other - Middle Name:NKEMDILIM JENNIFER
Other - Last Name:OBIDIGBO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, FNP, PMHNP
Mailing Address - Street 1:3024 VANNA LN
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1783
Mailing Address - Country:US
Mailing Address - Phone:804-528-9752
Mailing Address - Fax:804-409-8005
Practice Address - Street 1:2301 HILLIARD RD STE 4
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-4525
Practice Address - Country:US
Practice Address - Phone:804-546-4966
Practice Address - Fax:804-250-4583
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176472363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care