Provider Demographics
NPI:1245598846
Name:NGALLA-OLUKA, MELVIS E (NP)
Entity Type:Individual
Prefix:
First Name:MELVIS
Middle Name:E
Last Name:NGALLA-OLUKA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MELVIS
Other - Middle Name:E
Other - Last Name:NGALLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 W 14TH ST STE 1E30
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 W 14TH ST STE 1E30
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1013
Practice Address - Country:US
Practice Address - Phone:302-320-9660
Practice Address - Fax:302-320-9665
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0047893163W00000X
DEL8-0000189363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner