Provider Demographics
NPI:1952761504
Name:IKPEKPE, EUNICE
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:
Last Name:IKPEKPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EUNICE
Other - Middle Name:
Other - Last Name:IKPEKPE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:5916 EGRET LANDING PL
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-3963
Mailing Address - Country:US
Mailing Address - Phone:813-410-0232
Mailing Address - Fax:
Practice Address - Street 1:5916 EGRET LANDING PL
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-3963
Practice Address - Country:US
Practice Address - Phone:813-410-0232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9244896363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily