Provider Demographics
NPI:1619696044
Name:DAVID, EMILY NYAMBURA (PMHNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:NYAMBURA
Last Name:DAVID
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14698 BRIAR FOREST DR APT 2105
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-2587
Mailing Address - Country:US
Mailing Address - Phone:972-375-2134
Mailing Address - Fax:
Practice Address - Street 1:14698 BRIAR FOREST DR APT 2105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-2587
Practice Address - Country:US
Practice Address - Phone:972-375-2134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61346048363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health