Individual provider · Type 1 NPI
Samone Ighofose, NP-C
Primary Care Nurse Practitioner · Fairfax, VA
NPI number
1841764586
Active
Practice location
4400 University Dr
Fairfax, VA 22030-4422
Mailing address
1040 Huff Rd NW Apt 1204
Atlanta, GA 30318-4141
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | 233305 (GA) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | 0024176758 (VA) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1841764586
Samone Ighofose, NP-C's National Provider Identifier is 1841764586, issued on Jan 16, 2019. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Fairfax, VA. The record was last updated on Oct 8, 2021.