# AUDRACY GENIA MASSAKIDI MBOUSSI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1700745999
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | F407919 | NY | Yes |
| 163W00000X | Registered Nurse | NA | NY | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | F407919 | NY | Yes |

## Other

- **Enumeration date:** 01/21/2026
- **Last updated:** 06/26/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02997780 | — | NY |