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Individual

OMAKA MOKAMBE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, BSN

Contact information

Practice address
2318 W FALLCREEK CT, GRAND FORKS, ND 58201-5253
(248) 790-5926
Mailing address
2318 W FALLCREEK CT, GRAND FORKS, ND 58201-5253
(248) 790-5926

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R49699
ND
163WH0200X
Home Health Registered Nurse
R49699
ND
363LA2200X
Adult Health Nurse Practitioner
R49699
ND

Other

Enumeration date
06/04/2014
Last updated
07/11/2025
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