Individual
KOUASSI AKON EBROTTIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
719 N 25TH ST, RICHMOND, VA 23223-6539
(804) 780-0840
Mailing address
910 GODDIN ST APT 218, RICHMOND, VA 23231-3208
(281) 416-6698
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024194499
VA
Other
Enumeration date
02/11/2025
Last updated
09/11/2025
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