Felishia Michelle Iwenjiora, RN

Individual provider Active NPI Registered Nurse · Henrietta, NY

NPI 1073760971 · NPPES record last updated Aug 21, 2008

Key facts

NPI
1073760971
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
565539 (NY)
Practice address
5000 E Henrietta Rd Apt D11
Henrietta, NY 14467-8945
Phone
(202) 536-5217
NPI assigned
Aug 21, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
565539NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 565539 NY Yes

Addresses

Primary practice location

5000 E Henrietta Rd Apt D11
Henrietta, NY 14467-8945

Mailing address

5000 E Henrietta Rd Apt D11
Henrietta, NY 14467-8945
Phone (202) 536-5217

Other identifiers

IdentifierTypeStateIssuer
02857225MedicaidNY

Other providers in Henrietta, NY

All providers in Henrietta, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.