Individual
MARIETTA OLUWASEUN KOUGBLENOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN BSN
Contact information
Practice address
123 S 69TH ST, UPPER DARBY, PA 19082-3212
(800) 748-3243
Mailing address
30 HUNTER LN, CAMP HILL, PA 17011-2400
(800) 748-3243
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN766929
PA
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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