Evah Wangungu

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN206115 Issued in GA

Practice address

705 Dixie St
Carrollton, GA 30117-3818

Phone

(770) 838-8824

NPI assigned

Nov 2, 2016

Last updated

Jan 10, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Holistique Home Care Corporation

  • In Home Supportive Care Agency
  • Dallas, GA
  • NPI 1215682927
  NPD Authorized official

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1184176455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR",
            "address_2": "SUITE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-838-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173818",
            "telephone_number": "770-838-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGUNGU",
        "first_name": "EVAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN206115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurri Wallace, PT
• Candler Lindsey Walls Jr., RPH
• Hollis Paul Walls, D.M.D.
• Sheila Reece Walls
• Mari Lynne Walson, PT, DPT
• Jaime Lee Ward
• Paulisa Ward, MD
• Tanisha Nichelle Ward
• Catherine Elizabeth Warren, LCSW
• Richard Warren, M.D.

• Family Nurse Practitioner in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.