=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609728229
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HERVE CARLOS FEUKOU GABEUKA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/14/2026
-----------------------------------------------------
Last Update Date | 02/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 188 PINDAR ST
-----------------------------------------------------
City | GERRARDSTOWN
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25420-2207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-476-6218
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 188 PINDAR ST
-----------------------------------------------------
City | GERRARDSTOWN
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25420-2207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 109609
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------