Provider Demographics
NPI:1760936330
Name:JOSELYNE, NIMPAYE MAOMBI (MA)
Entity Type:Individual
Prefix:
First Name:NIMPAYE
Middle Name:MAOMBI
Last Name:JOSELYNE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:NIMPAYE
Other - Middle Name:MAOMBI
Other - Last Name:JOSELYNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:2701 17TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-5351
Mailing Address - Country:US
Mailing Address - Phone:309-779-2031
Mailing Address - Fax:
Practice Address - Street 1:2701 17TH ST
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-5351
Practice Address - Country:US
Practice Address - Phone:309-779-2031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide