Provider Demographics
NPI:1689355018
Name:NGAH, MIRABELLE RINGNYU NKAMBFU
Entity Type:Individual
Prefix:
First Name:MIRABELLE
Middle Name:RINGNYU NKAMBFU
Last Name:NGAH
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 1:602 CROSSOVER CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-2249
Mailing Address - Country:US
Mailing Address - Phone:281-902-9992
Mailing Address - Fax:
Practice Address - Street 1:602 CROSSOVER CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-2249
Practice Address - Country:US
Practice Address - Phone:281-902-9992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator