Provider Demographics
NPI:1982574406
Name:TOGBA, JOETTA TOKPAH
Entity type:Individual
Prefix:
First Name:JOETTA
Middle Name:TOKPAH
Last Name:TOGBA
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 1:1576 IVY MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-5727
Mailing Address - Country:US
Mailing Address - Phone:678-533-6300
Mailing Address - Fax:
Practice Address - Street 1:301 S CHURCH ST STE 135
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-5721
Practice Address - Country:US
Practice Address - Phone:678-533-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-10
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5023355363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty