Provider Demographics
NPI:1972279693
Name:AMAKOBE, ROSELYNE NYANGASI
Entity Type:Individual
Prefix:MRS
First Name:ROSELYNE
Middle Name:NYANGASI
Last Name:AMAKOBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N MADISON ST LOWR GROUND
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1439
Mailing Address - Country:US
Mailing Address - Phone:302-442-2232
Mailing Address - Fax:
Practice Address - Street 1:915 N MADISON ST LOWR GROUND
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1439
Practice Address - Country:US
Practice Address - Phone:302-442-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-22
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDE000014731204374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide