Provider Demographics
NPI:1801207261
Name:NKENGEH, EMMANUEL NGULEFAC (CNP, FNP)
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:NGULEFAC
Last Name:NKENGEH
Suffix:
Gender:M
Credentials:CNP, FNP
Other - Prefix:
Other - First Name:EMMANUEL
Other - Middle Name:N/A
Other - Last Name:NKENGEH NGULEFAC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:313 MARJORAM DR
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-7027
Mailing Address - Country:US
Mailing Address - Phone:301-300-1183
Mailing Address - Fax:
Practice Address - Street 1:313 MARJORAM DR
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-7027
Practice Address - Country:US
Practice Address - Phone:301-300-1183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-19
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.387140163W00000X
OHAPRN.CNP.024075363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse