Provider Demographics
NPI:1710456835
Name:NANSIKOMBI, CHRISTABELL BWOGI (LVN)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTABELL
Middle Name:BWOGI
Last Name:NANSIKOMBI
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 SABBATICAL ST APT 928
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76131-7547
Mailing Address - Country:US
Mailing Address - Phone:951-313-5109
Mailing Address - Fax:
Practice Address - Street 1:6301 SABBATICAL ST APT 928
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76131-7547
Practice Address - Country:US
Practice Address - Phone:951-313-5109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343078164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse