Provider Demographics
NPI:1427378702
Name:IGBO, NNENNA LUCY (MD)
Entity type:Individual
Prefix:DR
First Name:NNENNA
Middle Name:LUCY
Last Name:IGBO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-364-7070
Mailing Address - Fax:404-756-1313
Practice Address - Street 1:1000 JOHNSON FENY ROAD NE
Practice Address - Street 2:KAISER PERMANENTE AT NORTHSIDE HOSPITAL
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-851-8000
Practice Address - Fax:404-756-1313
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2022-01-14
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
GA070169207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program