Provider Demographics
NPI:1477056570
Name:EBOT, YVONNE MOKOU
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:MOKOU
Last Name:EBOT
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 1:2208 SEVILLE CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-5803
Mailing Address - Country:US
Mailing Address - Phone:972-365-1327
Mailing Address - Fax:
Practice Address - Street 1:2208 SEVILLE CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-5803
Practice Address - Country:US
Practice Address - Phone:972-365-1327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX219573164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse