Provider Demographics
NPI:1053954602
Name:IGWE, UDO (CRNP, FNP-BC, NP-C)
Entity type:Individual
Prefix:
First Name:UDO
Middle Name:
Last Name:IGWE
Suffix:
Gender:F
Credentials:CRNP, FNP-BC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20060-0001
Mailing Address - Country:US
Mailing Address - Phone:202-710-5541
Mailing Address - Fax:
Practice Address - Street 1:1201 MARYLAND AVE SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-6129
Practice Address - Country:US
Practice Address - Phone:202-488-0243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR176420363LF0000X, 163WX0003X, 363LF0000X
DCRN1005511363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, InpatientGroup - Multi-Specialty