MISS MANJERNGIE CECELIA NDEBE FNP-C PHD NPI 1063562585

NPI Information

NPI: 1063562585
Provider Name: MISS MANJERNGIE CECELIA NDEBE, FNP-C, PHD
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
451 W. MILHAM AVE
PORTAGE, MI
ZIP 49024
Phone: (269) 488-9008
Get Directions

MISS Manjerngie Cecelia Ndebe, FNP-C, PHD is a family nurse practitioner in Portage, MI with 24 years of experience. MISS Manjerngie Cecelia Ndebe, FNP-C, PHD NPI is 1063562585. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

451 W. MILHAM AVE
PORTAGE, MI
ZIP 49024
Phone: (269) 488-9008
Fax: (269) 488-9001

The NPI 1063562585 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/10/2007 and was last updated on 11/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	4704241860	MICHIGAN	No
2	363LF0000X	Nurse Practitioner	Family	4704241860	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	12016777	OTHER	MICHIGAN	BCBSM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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