Provider Demographics
NPI:1336412378
Name:IFEDILI, IJEOMA CHINEGO (ACNP-BC, CCRN)
Entity Type:Individual
Prefix:
First Name:IJEOMA
Middle Name:CHINEGO
Last Name:IFEDILI
Suffix:
Gender:F
Credentials:ACNP-BC, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P O BOX 1000 DEPT 351
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-758-9900
Mailing Address - Fax:901-752-2335
Practice Address - Street 1:3960 NEW COVINGTON PIKE
Practice Address - Street 2:METHODIST NORTH HOSPITAL
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-2504
Practice Address - Country:US
Practice Address - Phone:901-516-5587
Practice Address - Fax:901-516-5323
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN21072363LA2100X
NC215933363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care