Provider Demographics
NPI:1447140165
Name:NGALA EPSE NGAWE, YVETTE BONSIYSI
Entity type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:BONSIYSI
Last Name:NGALA EPSE NGAWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 PEARL AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-4252
Mailing Address - Country:US
Mailing Address - Phone:859-693-4396
Mailing Address - Fax:859-693-4396
Practice Address - Street 1:108 PEARL AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-4252
Practice Address - Country:US
Practice Address - Phone:859-693-4396
Practice Address - Fax:859-693-4396
Is Sole Proprietor?:No
Enumeration Date:2025-07-04
Last Update Date:2025-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2369404163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse