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MRS. IMOSE IDUBOR NP
NPI 1194466607
Nurse Practitioner - Psychiatric/Mental Health in Dacula, GA

Active since April 06, 2022
1067 IVEY CHASE PL, DACULA, GA 30019(678) 670-9626 Get Directions Write a Review

NPPES record last updated: April 11, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 11, 2022, Apr 6, 2022 (2 updates tracked since 2022).

About Mrs. Imose Idubor Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. IMOSE IDUBOR NP (NPI 1194466607) is an individual psychiatric/mental health provider in Dacula, Georgia, licensed in Georgia (RN261495) and active in the NPI registry since April 2022.

NPPES Registry Identity

NPI1194466607
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMRS. IMOSE IDUBORCredential: NP
Location Address1067 IVEY CHASE PLDacula, GA 30019-7866
Mailing Address1067 Ivey Chase PlDacula, GA 30019-7866 · (678) 670-9626
Phone(678) 670-9626
Sole ProprietorYes
Enumeration DateApril 6, 2022
Last NPPES UpdateApril 11, 20222 updates tracked since enumeration
NPPES CertifiedApril 11, 2022
✔ NPI 1194466607 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in GA · RN261495
1067 IVEY CHASE PL, Dacula, GA 30019
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Imose Idubor's NPI number?

The NPI number for Imose Idubor is 1194466607. It was assigned to this individual provider in the NPPES registry on April 6, 2022.

Where is Imose Idubor located?

Imose Idubor practices at 1067 Ivey Chase Pl, Dacula, GA 30019. The listed phone number is (678) 670-9626.

What is Imose Idubor's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Imose Idubor was last updated on April 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.