# MILDRED K OMOONGEH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1760945752
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WC0200X | Critical Care Medicine Registered Nurse | 855808 | TX | — |
| 363LF0000X | Family Nurse Practitioner | 231224 | AZ | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 231224 | AZ | Yes |

## Other

- **Enumeration date:** 04/08/2019
- **Last updated:** 08/12/2024