Provider Demographics
NPI:1356841878
Name:MOUSSAS, FRANCINE ILUNGA
Entity Type:Individual
Prefix:
First Name:FRANCINE
Middle Name:ILUNGA
Last Name:MOUSSAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 LEWIS CANYON DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-0310
Mailing Address - Country:US
Mailing Address - Phone:214-609-9315
Mailing Address - Fax:
Practice Address - Street 1:2240 LEWIS CANYON DR
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-0310
Practice Address - Country:US
Practice Address - Phone:214-609-9315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX917260163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse