Provider Demographics
NPI:1902160294
Name:ATEAWUNG, NGOASONG (NP)
Entity Type:Individual
Prefix:MRS
First Name:NGOASONG
Middle Name:
Last Name:ATEAWUNG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12501 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-9613
Mailing Address - Country:US
Mailing Address - Phone:915-747-3510
Mailing Address - Fax:
Practice Address - Street 1:12501 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-9613
Practice Address - Country:US
Practice Address - Phone:915-747-3510
Practice Address - Fax:202-545-0934
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
TX1111786363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No374U00000XNursing Service Related ProvidersHome Health Aide