Provider Demographics
NPI:1336602069
Name:ORIOHA, IRENE IFESINACHI (FNP)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:IFESINACHI
Last Name:ORIOHA
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 1:150 PINE FOREST DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77384-5303
Mailing Address - Country:US
Mailing Address - Phone:281-709-2555
Mailing Address - Fax:281-440-9915
Practice Address - Street 1:150 PINE FOREST DR STE 110
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-5303
Practice Address - Country:US
Practice Address - Phone:281-709-2555
Practice Address - Fax:281-440-9915
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138103363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty