Individual provider Active NPI

Gloria Funbi Igboin, MSN, RN, FNP, PMH-BC

  • Nurse Practitioner
  • Mount Vernon, IL
National Provider Identifier
1417517285
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11002204 Issued in FL
Practice address
4000 S Water Tower PL
Mount Vernon, IL 62864-2349
Phone
(618) 246-2910
NPI assigned
Jun 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11002204 FL Primary

Addresses

Primary practice location

4000 S Water Tower PL
Mount Vernon, IL 62864-2349

Mailing address

4001 S Water Tower PL Apt 234
Mount Vernon, IL 62864-6593
Phone (727) 424-8784

Other names 1

  • Miss Gloria Funbi Toyinbo Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
11002204FLMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1417517285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 S WATER TOWER PL APT 234",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646593",
            "telephone_number": "727-424-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 S WATER TOWER PL",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642349",
            "telephone_number": "618-246-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGBOIN",
        "first_name": "GLORIA",
        "middle_name": "FUNBI",
        "name_prefix": "Mrs.",
        "credential": "MSN, RN, FNP, PMH-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11002204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "TOYINBO",
            "middle_name": "FUNBI",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.