IndividualActive
Mnyisei Kamvazaana, NP
NPI 1376371708 · Obstetrics & Gynecology Nurse Practitioner · Lake Station, IN
Provider details
- NPI number
- 1376371708
- Entity type
- Individual
- Primary specialty
- Obstetrics & Gynecology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- License
- 71015457A (IN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2490 Central Ave
Lake Station, IN 46405-2122
Phone: (219) 763-8112
Approximate (ZIP-level) locationGet directions
Mailing address
2396 Butterfly Ln
Berrien Springs, MI 49103-8501
Registry dates
- Enumerated
- 2024-07-25
- Last updated
- 2024-07-25
- Certified
- 2024-07-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.