Provider Demographics
NPI:1972076743
Name:NDIAYE, NDEYE MARIEME (FNP)
Entity Type:Individual
Prefix:
First Name:NDEYE
Middle Name:MARIEME
Last Name:NDIAYE
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 1:900 W NIFONG BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4469
Mailing Address - Country:US
Mailing Address - Phone:573-815-6631
Mailing Address - Fax:573-815-6634
Practice Address - Street 1:900 W NIFONG BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4469
Practice Address - Country:US
Practice Address - Phone:573-815-6631
Practice Address - Fax:573-815-6634
Is Sole Proprietor?:No
Enumeration Date:2019-01-04
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018045160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily