Healthcare Provider Details

I. General information

NPI: 1386893386
Provider Name (Legal Business Name): ELIZABETH NINI VEBANGSI DNP/FNP/PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH NINI VEBANGSI DNP/FNP/PMHNP

II. Dates (important events)

Enumeration Date: 09/15/2008
Last Update Date: 09/15/2023
Certification Date: 09/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4514 BENNING RD SE
WASHINGTON DC
20019-5149
US

IV. Provider business mailing address

11801 BISHOPS CONTENT RD BOWIE MD 20721 11801 BISHOPS CONTENT RD SE
WASHINGTON DC DC
20019
US

V. Phone/Fax

Practice location:
  • Phone: 202-800-6500
  • Fax:
Mailing address:
  • Phone: 240-486-2783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN963620
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR150578
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: