MISS MANJERNGIE CECELIA NDEBE (NPI# 1063562585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063562585 |
Entity Type | Individual |
Full Name | MISS MANJERNGIE CECELIA NDEBE |
Credential | FNP-C, PHD |
Practice Address |
451 W. Milham Ave Portage MI 49024 |
Mailing Address |
P.o. Box 497 Portage MI 49081 |
Practice Telephone | 2694889008 |
Practice Fax Number | 2694889001 |
Mailing Telephone | 2694889008 |
Mailing Fax Number | 2694889001 |
Enumeration Date | 2007-01-10 |
Last Update Date | 2017-11-06 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704241860 | MI | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
4704241860 | MI | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | BCBSM | 12016777 | 01 |
Street Address |
451 W. MILHAM AVE |
City | PORTAGE |
State | MI |
Zip Code | 49024 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
Find all providers in zip 49024 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063031367 | Patricia Evelyn Biel | Nurse Practitioner | 5511 Redwood Avenue, Portage, IN 46368-4302 | 2020-04-16 |
1366092975 | Rachel Jaynu Nimely-scott | Nurse Practitioner | 5722 Kingman Ave, Portage, IN 46368-1529 | 2019-09-16 |
1174082523 | Upstream Health and Wellness, LLC | Nurse Practitioner | 3200 Willowcreek Rd Ste B, Portage, IN 46368-4486 | 2019-03-15 |
1972087161 | Danielle R Geroski | Nurse Practitioner | 9900 Huffman Rd, Portage, OH 43451-9739 | 2018-09-24 |
1780927889 | Marianne Harman | Nurse Practitioner | 6652 Lakewood Ave, Chhabra Medical Corporation PC, Portage, IN 46368-2404 | 2013-03-27 |
1164640884 | Barbara Jane Heric | Nurse Practitioner | 6615 S Boundary Rd, Portage, IN 46368-1373 | 2007-04-20 |
1982204640 | Kaitlyn Renea Davidson | Nurse Practitioner | 3304 Cooley Ct, Portage, MI 49024-7430 | 2020-10-30 |
1467052753 | Courtney Brooke Wyant | Nurse Practitioner | 3304 Cooley Ct, Portage, MI 49024-7430 | 2020-10-27 |
1114551777 | Kelsey Lankford | Nurse Practitioner | 7901 Angling Rd, Portage, MI 49024-0714 | 2020-02-23 |
1023642683 | April Klavinger | Nurse Practitioner | 7901 Angling Rd, Portage, MI 49024-0714 | 2020-02-23 |
Find all providers in PORTAGE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.