Individual
NICHOLAS NYAMBEGERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7250 NW EXPRESSWAY, STE 200, OKLAHOMA CITY, OK 73132-1534
(405) 525-0452
Mailing address
12724 NE 38TH ST, SPENCER, OK 73084-9155
(505) 553-8292
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100719930A
—
OK
Enumeration date
02/27/2013
Last updated
02/27/2013
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