Provider Demographics
NPI:1508560038
Name:AKA-EZOUA, EDOUKOU
Entity type:Individual
Prefix:
First Name:EDOUKOU
Middle Name:
Last Name:AKA-EZOUA
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 1:5822 ADDISON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-1204
Mailing Address - Country:US
Mailing Address - Phone:570-328-0735
Mailing Address - Fax:
Practice Address - Street 1:5822 ADDISON ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-1204
Practice Address - Country:US
Practice Address - Phone:570-328-0735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula