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Individual

KENNETH MBUEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
10562 TATTERSALL DR, MANASSAS, VA 20112-2407
(336) 740-6347
Mailing address
10562 TATTERSALL DR, MANASSAS, VA 20112-2407
(336) 740-6347

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024190787
VA

Other

Enumeration date
07/29/2024
Last updated
07/29/2024
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