Provider Demographics
NPI:1992741458
Name:NWEREM, IJEOMA CHINWE (FNP)
Entity type:Individual
Prefix:
First Name:IJEOMA
Middle Name:CHINWE
Last Name:NWEREM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 SE 182ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-5692
Mailing Address - Country:US
Mailing Address - Phone:503-661-3439
Mailing Address - Fax:503-669-1360
Practice Address - Street 1:2020 SE 182ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-5692
Practice Address - Country:US
Practice Address - Phone:503-661-3439
Practice Address - Fax:503-669-1360
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP77397Medicare UPIN