MEDICARE: NGWENGYI NKEH

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	363LP2300X	Primary Care Nurse Practitioner	212664	OK

General Provider Information

NPI Number	:	1912695677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGWENGYI NKEH

Provider Business Mailing Address
First Line	:	1669 GRACEHILL WAY
Second Line	:
City	:	FORNEY
State	:	TX
Zip	:	75126-4281
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 OPTUM CIR
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-2956
Country	:	US
Telephone Number	:	855-427-4682
Fax Number	:

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

Provider Enumeration Date	:	04/28/2023
Last Update Date	:	04/16/2025

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Directions to “ NGWENGYI NKEH ” Practice Location

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