Provider Demographics
NPI:1316523046
Name:MCGEE-IGIOZEE, WANDA (DNP)
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:MCGEE-IGIOZEE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 BRYAN ST
Mailing Address - Street 2:
Mailing Address - City:COTTONPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71327-4288
Mailing Address - Country:US
Mailing Address - Phone:318-220-1965
Mailing Address - Fax:
Practice Address - Street 1:5505 BROADWAY BLVD STE B
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-3671
Practice Address - Country:US
Practice Address - Phone:214-703-6527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1015656363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily