Individual
DR. NGUFOR FUBE DIVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP-PMH
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 808-1859
Mailing address
9001 HARFORD RD, PARKVILLE, MD 21234-4029
(410) 870-1590
(443) 558-7706
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R241388
MD
Other
Enumeration date
10/06/2022
Last updated
11/19/2025
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