Provider Demographics
NPI:1700078169
Name:AMORIN, CHARLOTTE DJAABA (APRN-FNP)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:DJAABA
Last Name:AMORIN
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17424 W GRAND PKWY S STE 416
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2564
Mailing Address - Country:US
Mailing Address - Phone:866-488-3103
Mailing Address - Fax:
Practice Address - Street 1:17424 W GRAND PKWY S STE 416
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2564
Practice Address - Country:US
Practice Address - Phone:281-690-0380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP115762363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y3668OtherBCBSTX
TX640737OtherLICENSE
TX640737OtherLICENSE