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Individual

MISS ADRIENNE NGELO AKENJI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
202 E ADAMS ST, ITASCA, TX 76055-2506
(254) 384-4862
Mailing address
4307 PALMER DR, MANSFIELD, TX 76063-3433

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
341103
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
341103
NURSE
TX
Enumeration date
02/19/2018
Last updated
06/11/2019
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