Individual
MISPA EWUBE NKONGHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2212 BALD EAGLE WAY, GRAND PRAIRIE, TX 75052-4138
(214) 900-2529
Mailing address
2212 BALD EAGLE WAY, GRAND PRAIRIE, TX 75052-4138
(214) 900-2529
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1050549
TX
Other
Enumeration date
08/15/2021
Last updated
10/17/2023
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