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General NPI Number Information
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NPI Number | 1043189400
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Entity Type | Individual
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Provider Name | TANDE LIFITA NGUVE APNP
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Gender | Male
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 01/03/2026
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Provider Practice Location Address
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Address Line | 208 E OLIN AVE STE 105
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City | MADISON
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State | WI
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Zip | 53713-1427
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Country | US
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Telephone | 630-251-4156
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Fax |
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Provider Business Mailing Address
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Address Line | 1265 JOHN Q HAMMONS DR
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City | MADISON
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State | WI
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Zip | 53717-1921
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Country | US
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Telephone | 608-251-4156
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1001340-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209033806
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 17589-33
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License Number State | WI
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