Individual
IFEYINWA IBEANU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
954 FORREST ST, BALTIMORE, MD 21202-4236
(410) 837-2135
Mailing address
1611 ROSEDALE HEIGHTS AVE, BALTIMORE, MD 21237-1306
(443) 326-0503
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R178898
MD
363LF0000X
Family Nurse Practitioner
Primary
R178898
MD
Other
Enumeration date
08/25/2016
Last updated
04/21/2023
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