Provider Demographics
NPI:1215559976
Name:NANSIKOMBI, RUTH (RN)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:NANSIKOMBI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 MASON LN
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-8760
Mailing Address - Country:US
Mailing Address - Phone:972-891-4352
Mailing Address - Fax:
Practice Address - Street 1:2909 MASON LN
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-8760
Practice Address - Country:US
Practice Address - Phone:972-891-4352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX755530163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse