Provider Demographics
NPI:1114780723
Name:NGWI TANYI, NJUI TABI (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:NJUI TABI
Middle Name:
Last Name:NGWI TANYI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 WOOLSEY RD APT A
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98903-5810
Mailing Address - Country:US
Mailing Address - Phone:647-885-9207
Mailing Address - Fax:
Practice Address - Street 1:409 S 12TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3114
Practice Address - Country:US
Practice Address - Phone:509-575-2949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61506444363LP2300X
TX1106827363LP2300X
MN10605363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care