Ikemefula Nwangburuka
Individual provider Active NPI Social Worker · Fort Novosel, AL
NPI 1669833778 · NPPES record last updated Jun 30, 2025
Key facts
- NPI
- 1669833778
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- C011516 (NC)
- Practice address
- 301 Andrews Ave
Fort Novosel, AL 36362 - Phone
- (334) 255-7028
- NPI assigned
- Mar 16, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C011516 | NC | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Social Worker | 104100000X | C011516 | NC | Yes |
Addresses
Primary practice location
301 Andrews Ave
Fort Novosel, AL 36362
Mailing address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (270) 798-8727
Other providers in Fort Novosel, AL
- Riley Jo Koldenhoven
- Nathan Hoi-King Kwan
- Rose Larsen
- Wendi-Jo Lewis
- Erica Murray
- Daniella M Pettinari
- Amanda Pouncey
- Lauren Quednow
- Andre D Sapp
- Paul Schultz
All providers in Fort Novosel, AL · Social Worker in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2025. 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.