Provider Demographics
NPI:1396417671
Name:NKAMANYANG, RITA LEMNGAN (DNP, CRNA)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:LEMNGAN
Last Name:NKAMANYANG
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3213
Mailing Address - Country:US
Mailing Address - Phone:757-215-3550
Mailing Address - Fax:
Practice Address - Street 1:3640 HIGH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3213
Practice Address - Country:US
Practice Address - Phone:757-215-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001241207163W00000X
IL209024378367500000X
IL209.024378367500000X
VA0024183121367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041518225OtherRN LICENSE