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General NPI Number Information
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NPI Number | 1073139325
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Entity Type | Individual
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Provider Name | LOUISE AKA EZOUA CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/23/2020
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 855 3RD AVE
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City | NEW YORK
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State | NY
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Zip | 10022-6609
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Country | US
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Telephone | 929-650-3990
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Fax |
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Provider Business Mailing Address
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Address Line | 855 3RD AVE
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City | NEW YORK
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State | NY
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Zip | 10022-6609
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP022076
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11041571
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ01078200
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License Number State | NJ
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