Provider Demographics
NPI:1811140809
Name:LOUANGA, LOUISE
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:LOUANGA
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 1:9707 HORACE HARDING EXPY
Mailing Address - Street 2:APT 12-L
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-4156
Mailing Address - Country:US
Mailing Address - Phone:718-760-2912
Mailing Address - Fax:
Practice Address - Street 1:9707 HORACE HARDING EXPY
Practice Address - Street 2:APT 12-L
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-4156
Practice Address - Country:US
Practice Address - Phone:718-760-2912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY604738163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse