Provider Demographics
NPI:1366060246
Name:IGWE, FAITH
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:IGWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 PECAN LEAF DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-2035
Mailing Address - Country:US
Mailing Address - Phone:469-630-5375
Mailing Address - Fax:
Practice Address - Street 1:515 PECAN LEAF DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-2035
Practice Address - Country:US
Practice Address - Phone:469-630-5375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX353584164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse