Provider Demographics
NPI:1508142431
Name:NGAMELUE, DOROTHY
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:
Last Name:NGAMELUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4980 SOUTH 118TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2200
Mailing Address - Country:US
Mailing Address - Phone:402-896-3884
Mailing Address - Fax:402-932-4854
Practice Address - Street 1:2216 AVERY RD E
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-4643
Practice Address - Country:US
Practice Address - Phone:402-502-8330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20021164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse