MEDICARE: REGINAH NYAMWAYA

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	163W00000X	Registered Nurse	4704245071	MI

General Provider Information

NPI Number	:	1730021437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINAH NYAMWAYA

Provider Business Mailing Address
First Line	:	1405 WOLCOTT AVE
Second Line	:
City	:	SAINT JOSEPH
State	:	MI
Zip	:	49085-1760
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1405 WOLCOTT AVE
Second Line	:
City	:	SAINT JOSEPH
State	:	MI
Zip	:	49085-1760
Country	:	US
Telephone Number	:	269-861-1684
Fax Number	:

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

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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