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General NPI Number Information
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NPI Number | 1184511677
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Entity Type | Individual
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Provider Name | TERESA WOTHAYA NJENGA PMNHNP
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Gender | Female
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 5017 HERITAGE AVE
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City | COLLEYVILLE
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State | TX
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Zip | 76034-5994
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Country | US
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Telephone | 817-545-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 14609 COMAL ST
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City | HASLET
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State | TX
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Zip | 76052-1189
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Country | US
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Telephone | 508-414-1354
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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 | 1116442
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License Number State | TX
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