Provider Demographics
NPI:1457125700
Name:NCUBE, SENELISIWE NOZIPHO (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SENELISIWE
Middle Name:NOZIPHO
Last Name:NCUBE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5355 WELLBORN CHASE
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-4557
Mailing Address - Country:US
Mailing Address - Phone:224-532-3534
Mailing Address - Fax:
Practice Address - Street 1:3030 MCEVER RD STE 130
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-5538
Practice Address - Country:US
Practice Address - Phone:678-450-0747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN264553363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily