Healthcare Provider Details

I. General information

NPI: 1992998215
Provider Name (Legal Business Name): THENJIWE NDEBELE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7322 RIDGE MEADOW CT
WEST CHESTER OH
45069-5854
US

IV. Provider business mailing address

7322 RIDGE MEADOW CT
WEST CHESTER OH
45069-5854
US

V. Phone/Fax

Practice location:
  • Phone: 513-545-4273
  • Fax: 513-428-8056
Mailing address:
  • Phone: 513-545-4273
  • Fax: 513-428-8056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.0028058
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN358224
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: