Provider Demographics
NPI:1831793710
Name:NJI, EMMANUEL KPWE (PMHNP-CNP)
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:KPWE
Last Name:NJI
Suffix:
Gender:
Credentials:PMHNP-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 SAN PEDRO DR NE STE 205F
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-6749
Mailing Address - Country:US
Mailing Address - Phone:903-957-0082
Mailing Address - Fax:903-957-0351
Practice Address - Street 1:1330 SAN PEDRO DR NE STE 205F
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-6749
Practice Address - Country:US
Practice Address - Phone:903-957-0082
Practice Address - Fax:903-957-0351
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020704363LP0808X
NM62092363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM850206810Medicaid