Basic Information
| Provider Information | |||||||||
| NPI: | 1083048748 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AKOUEGNON | ||||||||
| FirstName: | FLORENCE | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5223 W WOODMILL DR STE 41 | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198084068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3025167936 | ||||||||
| FaxNumber: | 3025106964 | ||||||||
| Practice Location | |||||||||
| Address1: | 5223 W WOODMILL DR STE 41 | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198084068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3025167936 | ||||||||
| FaxNumber: | 3025106964 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2013 | ||||||||
| LastUpdateDate: | 12/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QC1500X | LP-000135 | DE | N | Ambulatory Health Care Facilities | Clinic/Center | Community Health | 261QM0801X | LP-000135 | DE | N | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | 363LP0808X | LP-00013 | DE | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LP0808X | LP-000135 | DE | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LP2300X | LP-00013 | DE | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | 363LP2300X | LP-000135 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
No ID Information.