Individual
JACQUELINE N MBUYONGHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
4039 ELM TRACE DR, LOGANVILLE, GA 30052-5941
(678) 267-4487
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN191886
GA
Other
Enumeration date
03/23/2021
Last updated
03/23/2021
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