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General NPI Number Information
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NPI Number | 1477315778
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Entity Type | Individual
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Provider Name | NGETLA MBONUH DNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/23/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 110 PAINTERS MILL RD SUITE 101
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5531
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Country | US
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Telephone | 443-615-6840
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Fax |
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Provider Business Mailing Address
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Address Line | 3702 GUINEVERE TRCE
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-7766
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Country | US
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Telephone | 443-615-6840
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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 | APRN11026442
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License Number State | FL
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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 | AC007077
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License Number State | MD
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