Provider Demographics
NPI:1780350033
Name:NGUELEWOU, ELVIRA LEINYUY (FNP/ACNP)
Entity type:Individual
Prefix:
First Name:ELVIRA
Middle Name:LEINYUY
Last Name:NGUELEWOU
Suffix:
Gender:F
Credentials:FNP/ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 ROCKY BROOK CT
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-1471
Mailing Address - Country:US
Mailing Address - Phone:443-627-1629
Mailing Address - Fax:
Practice Address - Street 1:53 ROCKY BROOK CT
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-1471
Practice Address - Country:US
Practice Address - Phone:443-627-1629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR212332363LA2200X, 363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner