Individual
MRS. JOELLE DEMGNE KOUROUMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
106 IRVING ST NW STE 2100N, WASHINGTON, DC 20010-2927
(202) 877-8484
Mailing address
106 IRVING ST NW STE 2100N, WASHINGTON, DC 20010-2927
(202) 877-8484
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA031562
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0007054
PA LICENSE
MD
01
—
PA031562
PA LICENSE NUMBER
DC
Enumeration date
03/18/2019
Last updated
03/05/2020
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