Provider Demographics
NPI:1154167567
Name:MOMANYI, WINNIE NYARANGI
Entity type:Individual
Prefix:
First Name:WINNIE
Middle Name:NYARANGI
Last Name:MOMANYI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 E MAIN STREET
Mailing Address - Street 2:STE 403
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-7182
Mailing Address - Country:US
Mailing Address - Phone:302-983-2646
Mailing Address - Fax:302-369-3093
Practice Address - Street 1:314 E MAIN STREET
Practice Address - Street 2:STE 403
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7182
Practice Address - Country:US
Practice Address - Phone:302-983-2646
Practice Address - Fax:302-369-3093
Is Sole Proprietor?:No
Enumeration Date:2024-07-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL8-0010658363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health