Active NPI
Irene Iwenofu
- General Practice Registered Nurse
- Tumwater, WA
National Provider Identifier
1548031586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- 2002024223
- Practice address
- 6021 Darby CT SE
Tumwater, WA 98501-5312 - Phone
- (314) 475-0002
- NPI assigned
- Jan 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 2002024223 | MO | Primary |
Addresses
Primary practice location
6021 Darby CT SE
Tumwater, WA 98501-5312
Mailing address
6021 Darby CT SE
Tumwater, WA 98501-5312
Phone (314) 475-0002
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2002024223 | MO | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704758400000",
"number": "1548031586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6021 DARBY CT SE",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985015312",
"telephone_number": "314-475-0002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6021 DARBY CT SE",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985015312",
"telephone_number": "314-475-0002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IWENOFU",
"first_name": "IRENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-09",
"last_updated": "2024-01-09",
"certification_date": "2024-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, General Practice",
"state": "MO",
"license": "2002024223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tumwater, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.