Provider Demographics
NPI:1013605302
Name:VUCHANSU, JOSEPHINE NCHANGNWIE
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:NCHANGNWIE
Last Name:VUCHANSU
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 1:37048 AGNES WEBB AVE
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3397
Mailing Address - Country:US
Mailing Address - Phone:240-626-0607
Mailing Address - Fax:
Practice Address - Street 1:1100 RUTHERFORD ST
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-0957
Practice Address - Country:US
Practice Address - Phone:240-626-0607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA229773363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health