Provider Demographics
NPI:1568910966
Name:NGAMELUE-KOUEMO, MARTINE WELEHELALE (ARNP)
Entity Type:Individual
Prefix:
First Name:MARTINE
Middle Name:WELEHELALE
Last Name:NGAMELUE-KOUEMO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MARTINE
Other - Middle Name:WELEHELALE
Other - Last Name:NGAMELUE-KOUEMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 30589
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73140-3589
Mailing Address - Country:US
Mailing Address - Phone:405-769-3301
Mailing Address - Fax:405-769-9685
Practice Address - Street 1:300 MARTIN L KING
Practice Address - Street 2:
Practice Address - City:LANGSTON
Practice Address - State:OK
Practice Address - Zip Code:73050-1253
Practice Address - Country:US
Practice Address - Phone:405-466-2535
Practice Address - Fax:405-255-2554
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0082455363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily