Provider Demographics
NPI:1275124232
Name:NAMANGA, ANDINWE (CRNP-PMH)
Entity Type:Individual
Prefix:MRS
First Name:ANDINWE
Middle Name:
Last Name:NAMANGA
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12800 LEDO CREEK TER
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-5106
Mailing Address - Country:US
Mailing Address - Phone:240-688-2517
Mailing Address - Fax:
Practice Address - Street 1:12800 LEDO CREEK TER
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-5106
Practice Address - Country:US
Practice Address - Phone:240-688-2517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR208746363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty