Provider Demographics
NPI:1780980623
Name:ENEJE, NONYEREM ROSEMARY (DNP)
Entity type:Individual
Prefix:
First Name:NONYEREM
Middle Name:ROSEMARY
Last Name:ENEJE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LENORA ST # 984
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2411
Mailing Address - Country:US
Mailing Address - Phone:800-775-3207
Mailing Address - Fax:206-653-1033
Practice Address - Street 1:300 LENORA ST # 984
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2411
Practice Address - Country:US
Practice Address - Phone:800-775-3207
Practice Address - Fax:206-653-1033
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61061936363LP0808X, 363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily