Provider Demographics
NPI:1336194430
Name:RIBEIRO-ANDERSON, NSENGA (APRN, FNP-BC, ANP-BC)
Entity type:Individual
Prefix:MRS
First Name:NSENGA
Middle Name:
Last Name:RIBEIRO-ANDERSON
Suffix:
Gender:F
Credentials:APRN, FNP-BC, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6422 BRIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-4865
Mailing Address - Country:US
Mailing Address - Phone:314-363-6205
Mailing Address - Fax:
Practice Address - Street 1:6422 BRIDGECREST DR
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-4865
Practice Address - Country:US
Practice Address - Phone:314-363-6205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN144693363LA2200X
FL9464400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health