Provider Demographics
NPI:1144815978
Name:NFONTOH, NELSON NGWA (REGISTERED NURSE)
Entity type:Individual
Prefix:MR
First Name:NELSON
Middle Name:NGWA
Last Name:NFONTOH
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 8TH ST APT 205
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1216
Mailing Address - Country:US
Mailing Address - Phone:316-293-9126
Mailing Address - Fax:
Practice Address - Street 1:922 8TH ST APT 205
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1216
Practice Address - Country:US
Practice Address - Phone:316-293-9126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA149680163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0334076AZMedicaid