Provider Demographics
NPI:1982945937
Name:IKERI, ANGELA NGOZI (DNP, FNP-C, CWOCN)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:NGOZI
Last Name:IKERI
Suffix:
Gender:F
Credentials:DNP, FNP-C, CWOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55119-5043
Mailing Address - Country:US
Mailing Address - Phone:651-414-9102
Mailing Address - Fax:651-340-9099
Practice Address - Street 1:UNITED HOSPITAL
Practice Address - Street 2:333 NORTH SMITH AVE
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102
Practice Address - Country:US
Practice Address - Phone:651-241-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 153752-7163WC2100X, 163WH0200X, 163WR0400X, 163WW0000X, 163WX1500X
MN7770363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNF08200840Medicaid
MN1982945937Medicaid