Provider Demographics
NPI:1457178535
Name:NGNAMBALA, CAROLINE NKOBE
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:NKOBE
Last Name:NGNAMBALA
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 1:10025 STERLING PLACE DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77303-2003
Mailing Address - Country:US
Mailing Address - Phone:936-577-5820
Mailing Address - Fax:
Practice Address - Street 1:10025 STERLING PLACE DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77303-2003
Practice Address - Country:US
Practice Address - Phone:936-577-5820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1117894163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse