Provider Demographics
NPI:1780398727
Name:TAKWE, YVETTE N (CPMHNP)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:N
Last Name:TAKWE
Suffix:
Gender:F
Credentials:CPMHNP
Other - Prefix:
Other - First Name:YVETTE
Other - Middle Name:N
Other - Last Name:MBORINGONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10161 CAMPUS WAY S
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2105
Mailing Address - Country:US
Mailing Address - Phone:240-486-2500
Mailing Address - Fax:
Practice Address - Street 1:10504 MEADOWLAKE TER
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-3139
Practice Address - Country:US
Practice Address - Phone:240-486-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-12
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR223803163W00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse