Provider Demographics
NPI:1235853086
Name:NDUTI, ROSE NJAMBI (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:NJAMBI
Last Name:NDUTI
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11722 RASTELLO LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-4661
Mailing Address - Country:US
Mailing Address - Phone:832-722-7384
Mailing Address - Fax:
Practice Address - Street 1:11722 RASTELLO LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-4661
Practice Address - Country:US
Practice Address - Phone:832-722-7384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1094087363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1094087OtherTEXAS BOARD OF NURSING