Individual
MRS. CLARISSE VANESSA NGUEHA-NANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1233 N MAIN ST STE 10, SAN LUIS, AZ 85336-0663
(928) 722-6098
(928) 627-0007
Mailing address
PO BOX 1689, SAN LUIS, AZ 85349-1689
(928) 722-6098
(928) 627-0007
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP130813
TX
363LF0000X
Family Nurse Practitioner
Primary
AP8915
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163137
—
AZ
Enumeration date
07/27/2016
Last updated
10/21/2021
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