Provider Demographics
NPI:1134937832
Name:NSOUTOULA, ATCHIKITIA
Entity type:Individual
Prefix:
First Name:ATCHIKITIA
Middle Name:
Last Name:NSOUTOULA
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 1:1973 PRIDE GLN
Mailing Address - Street 2:
Mailing Address - City:RIO VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:94571-5201
Mailing Address - Country:US
Mailing Address - Phone:707-507-9696
Mailing Address - Fax:
Practice Address - Street 1:1973 PRIDE GLN
Practice Address - Street 2:
Practice Address - City:RIO VISTA
Practice Address - State:CA
Practice Address - Zip Code:94571-5201
Practice Address - Country:US
Practice Address - Phone:707-507-9696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker