Most Relevant Information
Provider Data
| NPI Number: | 1003641093 |
| Provider Name: | QUINTA AWAH-NDANG MBONGHO |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | P62494 |
Most Important Dates
| Enumeration Date: | 09/07/2024 |
| Last Updated: | 09/07/2024 |
Provider Practice Location
3600 30TH ST
DES MOINES
IA
503105753
Practice Location Phone/Fax
| Phone: | 5156995999 |
| Fax: |
Provider Mailing Location
3216 SE GRANT ST
ANKENY
IA
500219472
Provider Mailing Phone/Fax
| Phone: | 9083776245 |
| Fax: |