EBOTE NGITE NNOKO


Address: 108 Crescent Woode Dr, Dallas, GA 30157-5725
Phone: 7707025945

EBOTE NGITE NNOKO (NPI# 1346871696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346871696
Entity Type Individual
Full Name EBOTE NGITE NNOKO
Practice Address 108 Crescent Woode Dr
Dallas
GA 30157-5725
Practice Telephone 7707025945
Mailing Telephone 7707025945
Enumeration Date 2020-01-27
Last Update Date 2020-01-27
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
RN243114 GA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 108 CRESCENT WOODE DR
City DALLAS
State GA
Zip Code 30157-5725

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1851797294 Annette Moncion Nurse Practitioner 32 Midland Lane, Dallas, GA 30157 2014-11-12
1003211079 Melissa Brice Lactation Consultant, Non-RN 430 Parson Rd, Dallas, GA 30157 2014-11-03
1104101690 Jared Alan Lott Pharmacist 303 Charlie Watts Blvd, Dallas, GA 30157 2011-10-15
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City DALLAS
Zip Code 30157

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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