Individual
MRS. MAMBOH NGUM YUFENYUY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1657 SOUTHGATE MILL DR NW, DULUTH, GA 30096
(678) 977-5976
Mailing address
1657 SOUTHGATE MILL DR NW, DULUTH, GA 30096-8837
(678) 977-5976
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
17691
TN
363LA2200X
Adult Health Nurse Practitioner
Primary
RN188604
GA
363LF0000X
Family Nurse Practitioner
RN188604
GA
Other
Enumeration date
08/15/2012
Last updated
04/12/2022
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