Provider Demographics
NPI:1407725443
Name:NCHELEM, MEMMA N/A
Entity type:Individual
Prefix:
First Name:MEMMA
Middle Name:N/A
Last Name:NCHELEM
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 1:708 GLEN VALLEY WAY # A
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-4878
Mailing Address - Country:US
Mailing Address - Phone:470-818-3304
Mailing Address - Fax:470-818-3304
Practice Address - Street 1:708 GLEN VALLEY WAY
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-4878
Practice Address - Country:US
Practice Address - Phone:470-818-3304
Practice Address - Fax:470-818-3304
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN285047163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health