Individual
EDWIGE K NGUESSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 MAPLE ST, HOUSTON, DE 19954-2111
(678) 851-6785
Mailing address
130 MAPLE ST, HOUSTON, DE 19954-2111
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
LP-0010698
DE
363LG0600X
Gerontology Nurse Practitioner
Primary
2022002253
GA
Other
Enumeration date
08/21/2023
Last updated
10/16/2024
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