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General NPI Number Information
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NPI Number | 1457125700
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Entity Type | Individual
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Provider Name | SENELISIWE NOZIPHO NCUBE APRN
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Gender | Female
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Dates
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Enumeration Date | 11/08/2023
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Last Update Date | 04/27/2025
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Provider Practice Location Address
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Address Line | 150 HOSPITAL CIR
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City | CANTON
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State | GA
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Zip | 30114-3209
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Country | US
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Telephone | 770-479-5649
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Fax |
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Provider Business Mailing Address
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Address Line | 5355 WELLBORN CHASE
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City | CUMMING
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State | GA
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Zip | 30040-4557
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Country | US
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Telephone | 224-532-3534
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN264553
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License Number State | GA
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