Xaviera Pascale Nyandjo, PHARMD, RPH
Individual provider Active NPI Pharmacist · New Town, ND
NPI 1124641105 · NPPES record last updated May 25, 2020
Key facts
- NPI
- 1124641105
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH6202 (ND)
- Practice address
- 1058 College Dr
New Town, ND 58763-9112 - Phone
- (701) 627-7621
- NPI assigned
- May 25, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH6202 | ND | MD | Pharmacist |
| 63783 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 63783 | TX | |
| Pharmacist | 183500000X | RPH6202 | ND | Yes |
Addresses
Primary practice location
1058 College Dr
New Town, ND 58763-9112
Mailing address
1058 College Dr
New Town, ND 58763-9112
Phone (701) 627-7621
Other names
- Xaviera Pascale Djoko Mekouguem
Other providers in New Town, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.