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Individual

GEORGIANA NCHOTEBAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
715 OAK HALL LN, BALLWIN, MO 63021-7574
(314) 358-0140
Mailing address
715 OAK HALL LN, BALLWIN, MO 63021-7574

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
2016012207
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
AP131155
TX
363LG0600X
Gerontology Nurse Practitioner
2016012207
MO
363LG0600X
Gerontology Nurse Practitioner
AP131155
TX

Other

Enumeration date
07/01/2016
Last updated
07/01/2016
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