Provider Demographics
NPI:1518216571
Name:NYAMBI, ERNEST
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:
Last Name:NYAMBI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 MUIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-5338
Mailing Address - Country:US
Mailing Address - Phone:240-475-2401
Mailing Address - Fax:
Practice Address - Street 1:9800 MUIRFIELD DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-5338
Practice Address - Country:US
Practice Address - Phone:240-475-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSTILL TO BE AWARDED164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse