Gloria Oluchi Ikonne
Nurse Practitioner, Family in Carrollton, TX. Individual provider (NPI-1).
NPI number1114536364
StatusActive
Last updated in NPPESJul 23, 2020
Details
- NPI
- 1114536364
- Entity type
- Individual (NPI-1)
- Name
- Gloria Oluchi Ikonne
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 23, 2020
- Certification date
- Jul 23, 2020
- Last updated
- Jul 23, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | AP146154 | TX | Yes |
Practice location
1001 East Hebron Pkwy Suite 118-297Carrollton, TX 75010-1015
Phone 469-381-9070
Mailing address
4620 Ridge LnCarrollton, TX 75010-1210
Phone 469-381-9070
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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