Provider Demographics
NPI:1770040487
Name:NNAMANI, NADEGE NGUETSOP (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NADEGE
Middle Name:NGUETSOP
Last Name:NNAMANI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3338 VIEW VALLEY TRL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-4443
Mailing Address - Country:US
Mailing Address - Phone:708-250-6050
Mailing Address - Fax:
Practice Address - Street 1:8840 CYPRESS WATERS BLVD STE 300
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4630
Practice Address - Country:US
Practice Address - Phone:469-417-7522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10405363LP0808X
NM73266363LP0808X
TXAP139700363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty