Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 0024180198 | VA |
NPI | 1508195991 |
---|---|
Provider Name | Mrs. Bessem Ojong Adeso |
First Address | Ashland, VA 23005-7871 |
Second Address | Ashland, VA 23005-7871 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2009 |
Last Update Date | 07/09/2021 |