Individual
IMMACULATE NGWE MBONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
100 MERRIMACK ST, LOWELL, MA 01852-1708
(978) 455-0756
Mailing address
60 KINGS FIELD RD, DRACUT, MA 01826-1269
(978) 726-2878
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
AC007215
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2289761
MA
Other
Enumeration date
02/22/2021
Last updated
02/04/2026
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