Provider Demographics
NPI:1245504588
Name:INYANG, IMMACULATA EME (FNP)
Entity type:Individual
Prefix:
First Name:IMMACULATA
Middle Name:EME
Last Name:INYANG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7125 MARVIN D LOVE FWY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3155
Mailing Address - Country:US
Mailing Address - Phone:214-607-3650
Mailing Address - Fax:214-382-0950
Practice Address - Street 1:7125 MARVIN D LOVE FWY
Practice Address - Street 2:SUITE 207
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3155
Practice Address - Country:US
Practice Address - Phone:214-607-3650
Practice Address - Fax:214-382-0950
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-05
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX808591363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX808591OtherTEXAS BOARD OF NURSING