MEDICARE: DR. REBEKAH NDINDA NGEWA CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	RN290233	GA
2	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	RN290233	GA
3	367A00000X	Advanced Practice Midwife	RN290233	GA

General Provider Information

NPI Number	:	1720726946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBEKAH NDINDA NGEWA CNM

Provider Business Mailing Address
First Line	:	40 PEACHTREE VALLEY RD NE APT 1813
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-8008
Country	:	US
Telephone Number	:	404-913-3454
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 PEACHTREE VALLEY RD NE APT 1813
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-8008
Country	:	US
Telephone Number	:	404-913-3454
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2022
Last Update Date	:	05/26/2022

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