Provider Demographics
NPI:1588832604
Name:NGANGA, ERNEST MUHORO (LPN)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:MUHORO
Last Name:NGANGA
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 WILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2219
Mailing Address - Country:US
Mailing Address - Phone:440-232-8103
Mailing Address - Fax:
Practice Address - Street 1:179 WILLARD AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2219
Practice Address - Country:US
Practice Address - Phone:440-232-8103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH121570164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse