Provider Demographics
NPI:1043790892
Name:CHIFAMBA, NGONIDZASHE (APRN , CNP)
Entity Type:Individual
Prefix:MR
First Name:NGONIDZASHE
Middle Name:
Last Name:CHIFAMBA
Suffix:
Gender:M
Credentials:APRN , CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 KNIGHTS BRIDGE DR W
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9667
Mailing Address - Country:US
Mailing Address - Phone:614-330-1724
Mailing Address - Fax:
Practice Address - Street 1:3080 CENTREVILLE RD STE 200
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-3715
Practice Address - Country:US
Practice Address - Phone:571-449-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily