Individual provider · Type 1 NPI
Mirabel Ngwe Boma
Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist · Washington, DC
NPI number
1063192235
Active
Practice location
2811 Pennsylvania Ave SE
Washington, DC 20020-3865
Mailing address
7708 Lexington Ave
Laurel, MD 20707-5835
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist Primary | 364SP0813X | NP1054131 (DC) |
| Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0813X | R238558 (MD) |
| Registered Nurse | 163W00000X | RN1054131 (DC) |
Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist: Definition to come...
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About NPI 1063192235
Mirabel Ngwe Boma's National Provider Identifier is 1063192235, issued on Jul 21, 2023. The primary taxonomy on file is Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist (364SP0813X), and the practice location is in Washington, DC. The record was last updated on Oct 20, 2025.