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Individual

DR. JOANN OSEDEBAME IKENYEI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1950 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3129
(303) 485-3066
(303) 485-3060
Mailing address
PO BOX 800022, KANSAS CITY, MO 64180-0022
(800) 953-0104
(303) 765-6670

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1980
WI
207R00000X
Internal Medicine Physician
DR.0066875
CO
208M00000X
Hospitalist Physician
18181
ND
208M00000X
Hospitalist Physician
1980
WI
208M00000X
Hospitalist Physician
Primary
DR.0066875
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100287144
WI
Enumeration date
04/06/2018
Last updated
03/25/2025
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