MEDICARE: CONSTANCE NJAWE NAMBUH

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	363LF0000X	Family Nurse Practitioner	AP140051	TX

General Provider Information

NPI Number	:	1598239444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONSTANCE NJAWE NAMBUH

Provider Business Mailing Address
First Line	:	820 IDLEWOOD DR
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75002-1826
Country	:	US
Telephone Number	:	214-457-9571
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 IDLEWOOD DR
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75002-1826
Country	:	US
Telephone Number	:	214-457-9571
Fax Number	:

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

Provider Enumeration Date	:	01/14/2019
Last Update Date	:	01/14/2019

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Directions to “ CONSTANCE NJAWE NAMBUH ” Practice Location

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