Provider Demographics
NPI:1508195991
Name:ADESO, BESSEM OJONG
Entity Type:Individual
Prefix:MRS
First Name:BESSEM
Middle Name:OJONG
Last Name:ADESO
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 1:12306 QUAIL OAK CT
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-7871
Mailing Address - Country:US
Mailing Address - Phone:804-852-2847
Mailing Address - Fax:434-217-1674
Practice Address - Street 1:12306 QUAIL OAK CT
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-7871
Practice Address - Country:US
Practice Address - Phone:804-852-2847
Practice Address - Fax:434-217-1674
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180198363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health