Individual
JEANDANIEL KOUOWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3840 HULEN ST, FORT WORTH, TX 76107-7277
(817) 335-3022
Mailing address
4228 WISCONSIN AVE NW, WASHINGTON, DC 20016-2138
(202) 926-7036
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
818269
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1175721
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
500013883
DC
Other
Enumeration date
08/11/2023
Last updated
02/07/2025
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