Individual
BETTY MBANGWANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1588 DRAYTON CT, PORTAGE, MI 49002-7293
(774) 823-9101
Mailing address
1312 OAKLAND DR, KALAMAZOO, MI 49008-1205
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704310944
MI
363LF0000X
Family Nurse Practitioner
Primary
4704310944
MI
Other
Enumeration date
04/27/2021
Last updated
04/27/2021
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