Mirabel Ngwe Boma

Primary specialty

Geropsychiatric Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0813X

License

NP1054131 Issued in DC

Practice address

2811 Pennsylvania Ave SE
Washington, DC 20020-3865

Phone

(202) 894-6811

NPI assigned

Jul 21, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1063192235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7708 LEXINGTON AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075835",
            "telephone_number": "304-988-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 PENNSYLVANIA AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200203865",
            "telephone_number": "202-894-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMA",
        "first_name": "MIRABEL",
        "middle_name": "NGWE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-21",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0813X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Geropsychiatric",
            "state": "DC",
            "license": "NP1054131",
            "primary": true
        },
        {
            "code": "364SP0813X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Geropsychiatric",
            "state": "MD",
            "license": "R238558",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1054131",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quentin Bolton, MD
• Robert Bolton
• Victoria Camilla Bolton
• Caroline Boma
• Giselle Boma
• Deborah Anne Bombard, PA-C
• Funmilayo Dupe Bombata
• Valerie Bonanjah
• Lemara Bonaparte
• Bonateh Care Services, LLC

• Clinical Nurse Specialist in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Nurse Specialist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.