Provider Demographics
NPI:1528868098
Name:TINEGA, WYCLIFFE NYAMONGO
Entity type:Individual
Prefix:
First Name:WYCLIFFE
Middle Name:NYAMONGO
Last Name:TINEGA
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 CHENEY RIDGE RD APT 6
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3803
Mailing Address - Country:US
Mailing Address - Phone:402-613-5009
Mailing Address - Fax:402-613-5009
Practice Address - Street 1:8200 CHENEY RIDGE RD APT 6
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3803
Practice Address - Country:US
Practice Address - Phone:402-613-5009
Practice Address - Fax:402-613-5009
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide