MEDICARE: NONYEREM ROSEMARY ENEJE DNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61061936	WA
2	363L00000X	Nurse Practitioner	AP61061936	WA
3	363LF0000X	Family Nurse Practitioner	AP61061936	WA

General Provider Information

NPI Number	:	1780980623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NONYEREM ROSEMARY ENEJE DNP

Provider Business Mailing Address
First Line	:	300 LENORA ST # 984
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98121-2411
Country	:	US
Telephone Number	:	800-775-3207
Fax Number	:	206-653-1033

Provider Business Practice Location Address
First Line	:	300 LENORA ST # 984
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98121-2411
Country	:	US
Telephone Number	:	800-775-3207
Fax Number	:	206-653-1033

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

Provider Enumeration Date	:	02/09/2011
Last Update Date	:	06/17/2024

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