Michele Mba

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN1013158 Issued in DC

Practice address

5101 Wisconsin Ave NW
Washington, DC 20016-4120

Phone

(202) 618-9125

NPI assigned

Nov 15, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1790115418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 UPSAL ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324123",
            "telephone_number": "202-945-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200164120",
            "telephone_number": "202-618-9125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "761 Upsal St SE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200324123",
            "country_code": "US",
            "telephone_number": "202-945-7067",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7826 Eastern Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200121324",
            "country_code": "US",
            "telephone_number": "202-525-2132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MBA",
        "first_name": "MICHELE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-15",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "DC",
            "license": "RN1013158",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "RN1013158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace A Mba
• Harriette Mba
• Jerry Tezock Mba
• Marcelle Tatiana Mba
• Masazew Ndedseh Mba
• Nchuyekeh Akweseh Mba
• Rajad Mba
• Senwu N Mba
• William Mba, HHA
• Stella Mbabid

• Psychiatric/Mental Health Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Psychiatric/Mental Health Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.