Provider Demographics
NPI:1144814955
Name:IGBINAKENZUA, EHIMWENMA JUDITH
Entity type:Individual
Prefix:
First Name:EHIMWENMA
Middle Name:JUDITH
Last Name:IGBINAKENZUA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EHIMWENMA
Other - Middle Name:JUDITH
Other - Last Name:RYANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5841 RIDGELINE DR
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-8603
Mailing Address - Country:US
Mailing Address - Phone:205-200-5135
Mailing Address - Fax:
Practice Address - Street 1:500 22ND ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-3110
Practice Address - Country:US
Practice Address - Phone:205-801-8624
Practice Address - Fax:205-801-8284
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-150986163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse