Individual
MIRABEL NGWE BOMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2811 PENNSYLVANIA AVE SE, WASHINGTON, DC 20020-3865
(202) 894-6811
Mailing address
7708 LEXINGTON AVE, LAUREL, MD 20707-5835
(304) 988-6000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN1054131
DC
364SP0813X
Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
Primary
NP1054131
DC
364SP0813X
Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
R238558
MD
Other
Enumeration date
07/21/2023
Last updated
10/20/2025
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