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Individual

MR. YVES-AIME AMOUGOU AMOUGOU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP-BC, FNP-C

Contact information

Practice address
KAISER PERMANENTE BEHAVIORAL HEALTH, 1100 LAKE HEARN DRIVE, SANDY SPRINGS, GA 30342
(404) 365-0966
Mailing address
175 DUBLIN WAY, DALLAS, GA 30132
(678) 523-7607

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
212975
GA
363L00000X
Nurse Practitioner
Primary
APRN-212975
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003194359A
GA
Enumeration date
10/11/2016
Last updated
04/14/2022
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