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General NPI Number Information
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NPI Number | 1730514381
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Entity Type | Individual
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Provider Name | QUEENDROLINE NKEH
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Gender | Female
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Dates
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Enumeration Date | 09/13/2013
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 265 FRANKLIN ST STE 1702
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City | BOSTON
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State | MA
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Zip | 02110-3144
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Country | US
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Telephone | 240-486-8941
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Fax |
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Provider Business Mailing Address
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Address Line | 1995 WINDING CREEK DR
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City | MARION
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State | IA
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Zip | 52302-6444
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Country | US
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Telephone | 240-486-8941
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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 | C-APN.0101297-C-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 | RN2375954
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License Number State | MA
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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 | G171992
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License Number State | IA
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