Provider Demographics
NPI:1942939780
Name:NGES, MANKA MARY-CLOTHILDA (FNP)
Entity Type:Individual
Prefix:
First Name:MANKA
Middle Name:MARY-CLOTHILDA
Last Name:NGES
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 1:480 GLYNN ST N
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-1192
Mailing Address - Country:US
Mailing Address - Phone:770-461-3431
Mailing Address - Fax:
Practice Address - Street 1:480 GLYNN ST N
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-1192
Practice Address - Country:US
Practice Address - Phone:770-461-3431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN222669363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily