Provider Demographics
NPI:1598020430
Name:NGO MAYEBA, NGONDA'YEBENIT NZELLE (NP)
Entity type:Individual
Prefix:
First Name:NGONDA'YEBENIT
Middle Name:NZELLE
Last Name:NGO MAYEBA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 SANFORD DR STE B
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-2576
Mailing Address - Country:US
Mailing Address - Phone:828-430-9120
Mailing Address - Fax:855-857-7333
Practice Address - Street 1:329 SANFORD DR STE B
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-2576
Practice Address - Country:US
Practice Address - Phone:828-430-9120
Practice Address - Fax:855-857-7333
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010187363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily