Provider Demographics
NPI:1811670201
Name:NYABWA, THOMAS
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:NYABWA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7932 SILVER LEAF CT APT D
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-6031
Mailing Address - Country:US
Mailing Address - Phone:667-232-0474
Mailing Address - Fax:
Practice Address - Street 1:7932 SILVER LEAF CT APT D
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-6031
Practice Address - Country:US
Practice Address - Phone:667-232-0474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRSA-01442163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health