Provider Demographics
NPI:1578041109
Name:NTUEN, NKOYO
Entity Type:Individual
Prefix:
First Name:NKOYO
Middle Name:
Last Name:NTUEN
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 1:12215 ANGELINA DR
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-7090
Mailing Address - Country:US
Mailing Address - Phone:267-815-5035
Mailing Address - Fax:
Practice Address - Street 1:12215 ANGELINA DR
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831
Practice Address - Country:US
Practice Address - Phone:267-815-5035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
COPN.0332716164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No251E00000XAgenciesHome Health