Provider Demographics
NPI:1891033221
Name:INGWU, AKPANA (LPN)
Entity type:Individual
Prefix:
First Name:AKPANA
Middle Name:
Last Name:INGWU
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13031 223RD ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-1243
Mailing Address - Country:US
Mailing Address - Phone:347-605-3901
Mailing Address - Fax:
Practice Address - Street 1:CREEDMOOR PSYCHIATRIC CENTER 79-25 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2199
Practice Address - Country:US
Practice Address - Phone:718-264-4137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312542164W00000X
NY779569163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse