Individual
NELSON SIMBA OGEMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1 WICKERSHAM ST, MANGUM, OK 73554-9117
(580) 782-3353
Mailing address
116 E PIERCE ST STE 500, MANGUM, OK 73554-4206
(972) 693-0734
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
217141
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201250440A
—
OK
01
—
217141
OKLAHOMA BOARD OF NURSING
OK
Enumeration date
01/20/2022
Last updated
10/25/2024
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