Individual
ETA BEA MUSONGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
717 S 30TH ST, HEATH, OH 43056-1294
(740) 522-1171
Mailing address
717 S 30TH ST, HEATH, OH 43056-1294
(631) 889-5094
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0033518
OH
Other
Enumeration date
05/15/2023
Last updated
11/11/2024
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