Provider Demographics
NPI:1922565464
Name:MOMA, SYLVIENASH BINWIE (DNP APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:SYLVIENASH
Middle Name:BINWIE
Last Name:MOMA
Suffix:
Gender:F
Credentials:DNP APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 LAKEWOOD CIR STE B114
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-4629
Mailing Address - Country:US
Mailing Address - Phone:719-597-4768
Mailing Address - Fax:
Practice Address - Street 1:411 LAKEWOOD CIR STE B114
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-4629
Practice Address - Country:US
Practice Address - Phone:719-597-4768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0994333363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily