Provider Demographics
NPI:1568226959
Name:METUGE, GLORY NGOH (NP)
Entity Type:Individual
Prefix:
First Name:GLORY
Middle Name:NGOH
Last Name:METUGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:GLORY
Other - Middle Name:NGOH
Other - Last Name:ETUBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7815 STOVALL CT
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4330
Mailing Address - Country:US
Mailing Address - Phone:703-477-5495
Mailing Address - Fax:
Practice Address - Street 1:7815 STOVALL CT
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4330
Practice Address - Country:US
Practice Address - Phone:703-477-5495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189324363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health