Individual
MELISSA NGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1743 WATSON BLVD STE A, WARNER ROBINS, GA 31093-3622
(478) 328-9690
(478) 328-9692
Mailing address
1743 WATSON BLVD STE A, WARNER ROBINS, GA 31093-3622
(478) 328-9690
(478) 328-9692
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN245179
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018020307
CERTIFICATION NUMBER
GA
01
—
RN245179
NP LICENSURE
GA
Enumeration date
09/11/2018
Last updated
09/11/2018
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