Individual
DR. IKE IKPONMWOSA IYAMU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, CRNA
Contact information
Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5076
(575) 532-4432
(575) 532-4431
Mailing address
2471 CONCHAS LN, LAS CRUCES, NM 88011-1733
(713) 591-2433
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
118612
NM
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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