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Individual

MERCY OTUOMAGIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1009 S BROADWAY ST, LA PORTE, TX 77571-5327
(281) 471-4202
Mailing address
1009 S BROADWAY ST, LA PORTE, TX 77571-5327
(281) 471-4202

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
579705
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
579705
TEXAS RN LICENSE
TX
Enumeration date
08/07/2007
Last updated
08/07/2007
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