Ifeanyi Nwaokolo
Individual provider Active NPI Driver · Saint Louis, MO
NPI 1134035488 · NPPES record last updated Aug 19, 2026
Key facts
- NPI
- 1134035488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 13440 Kingscross LN
Saint Louis, MO 63141-7224 - Phone
- (314) 682-9695
- NPI assigned
- Aug 19, 2026
- Sex
- Male
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
13440 Kingscross LN
Saint Louis, MO 63141-7224
Mailing address
13440 Kingscross LN
Saint Louis, MO 63141-7224
Phone (314) 682-9695
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.