Provider Demographics
NPI:1659110252
Name:MUMA, HENRY ASONGWE (FNP-C)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:ASONGWE
Last Name:MUMA
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4311 GOLDEN EAGLE CT NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-7034
Mailing Address - Country:US
Mailing Address - Phone:505-310-4296
Mailing Address - Fax:
Practice Address - Street 1:4311 GOLDEN EAGLE CT NE APT D306
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-7034
Practice Address - Country:US
Practice Address - Phone:505-310-4296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14594363LF0000X
NM79126363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily