MEDICARE: MELVIS KIMBENG TAMBI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0400X	Case Management Registered Nurse	1219144	TX

General Provider Information

NPI Number	:	1003764424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELVIS KIMBENG TAMBI

Provider Business Mailing Address
First Line	:	712 PROVERBS COURT
Second Line	:
City	:	HEATH
State	:	TX
Zip	:	75126
Country	:	US
Telephone Number	:	763-516-5272
Fax Number	:	763-516-5272

Provider Business Practice Location Address
First Line	:	712 PROVERBS COURT
Second Line	:
City	:	HEATH
State	:	TX
Zip	:	75126
Country	:	US
Telephone Number	:	763-516-5272
Fax Number	:	763-516-5272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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Directions to “ MELVIS KIMBENG TAMBI ” Practice Location

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