Provider Demographics
NPI:1740518968
Name:WHITFIELD, IJEOMA J (FNP-BC)
Entity type:Individual
Prefix:
First Name:IJEOMA
Middle Name:J
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10211 GOLDENVIEW PARK LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-2185
Mailing Address - Country:US
Mailing Address - Phone:832-343-9778
Mailing Address - Fax:713-772-8670
Practice Address - Street 1:10211 GOLDENVIEW PARK LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-2185
Practice Address - Country:US
Practice Address - Phone:832-343-9778
Practice Address - Fax:713-772-8670
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-29
Last Update Date:2009-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX689838363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily