Individual
DR. MARIAGORETTI LUMNWI NIBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1301 TAYLOR ST STE 1A, COLUMBIA, SC 29201-2946
(803) 434-4790
(803) 434-4799
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(225) 302-2253
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
214982
LA
363LF0000X
Family Nurse Practitioner
Primary
24275
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6866
—
SC
Enumeration date
08/10/2020
Last updated
03/26/2021
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