Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Betty Mbangwana

Individual provider Nurse Practitioner · NPI 1528640638

Betty Mbangwana is a Nurse Practitioner in Portage, Michigan. Qualified in 2020, 6 years ago. Practices with Theoria Medical, a 342-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
6
Licensed in
MI
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

1588 Drayton Ct
Portage, MI 49002-7293
Phone: (774) 823-9101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704310944 (MI)
Nurse Practitioner Taxonomy 363L00000X · Licence 4704310944 (MI)

Record details

NPI number1528640638
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 27, 2021
Last updated in NPPESApril 27, 2021
Certification dateApril 27, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Theoria Medical — 342 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Portage