Provider Demographics
NPI:1003789470
Name:IGWE, IJEOMA AUGUSTA (LPN)
Entity type:Individual
Prefix:MRS
First Name:IJEOMA
Middle Name:AUGUSTA
Last Name:IGWE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9983 JACKSON ST SE
Mailing Address - Street 2:
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597-7743
Mailing Address - Country:US
Mailing Address - Phone:253-232-4541
Mailing Address - Fax:253-679-1276
Practice Address - Street 1:9983 JACKSON ST SE
Practice Address - Street 2:
Practice Address - City:YELM
Practice Address - State:WA
Practice Address - Zip Code:98597-7743
Practice Address - Country:US
Practice Address - Phone:253-232-4541
Practice Address - Fax:253-679-1276
Is Sole Proprietor?:No
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60561397164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse