Provider Demographics
NPI:1487955944
Name:IGBOELI, CHINYERE JULIA (CRNA)
Entity type:Individual
Prefix:
First Name:CHINYERE
Middle Name:JULIA
Last Name:IGBOELI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CEDAR ST
Mailing Address - Street 2:P.O. BOX 208051
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3206
Mailing Address - Country:US
Mailing Address - Phone:203-737-1549
Mailing Address - Fax:203-785-6664
Practice Address - Street 1:333 CEDAR ST
Practice Address - Street 2:TMP 3
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3206
Practice Address - Country:US
Practice Address - Phone:203-737-1549
Practice Address - Fax:203-785-6664
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT096404163W00000X
CT4631367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse