Provider Demographics
NPI:1598479479
Name:NOSIMBANG, NJUAMBO PRUDENCE (FNP)
Entity type:Individual
Prefix:
First Name:NJUAMBO
Middle Name:PRUDENCE
Last Name:NOSIMBANG
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7560 JOSHUA RD
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-3382
Mailing Address - Country:US
Mailing Address - Phone:409-256-0877
Mailing Address - Fax:
Practice Address - Street 1:143 S DENTON TAP RD STE 180
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-3375
Practice Address - Country:US
Practice Address - Phone:469-564-1119
Practice Address - Fax:512-782-9316
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1191343363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily