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General NPI Number Information
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NPI Number | 1225477086
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Entity Type | Individual
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Provider Name | EMILY NYAMOKO NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 5675 N FRONT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19120-2719
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Country | US
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Telephone | 267-393-5197
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Fax |
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Provider Business Mailing Address
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Address Line | 305 NEWGATE RD
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City | LANGHORNE
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State | PA
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Zip | 19047-8252
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Country | US
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Telephone | 267-393-5197
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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 | SP028563
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP012905
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License Number State | PA
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