Individual provider · NPI-1

Adeline Etoghe Abam, APRN-CNP

Nurse Practitioner, Psych/Mental Health · Fort Worth, TX

NPI number1902277056
StatusActive
Last updated in NPPESMay 25, 2021

Details

NPI
1902277056
Entity type
Individual (NPI-1)
Name
Adeline Etoghe Abam
Credential
APRN-CNP
Sex
Female
Sole proprietor
No
Enumeration date
Oct 15, 2015
Certification date
May 25, 2021
Last updated
May 25, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0808X Nurse Practitioner, Psych/Mental HealthAP129503TXYes
363LC0200X Nurse Practitioner, Critical Care Medicine786779TX
363LF0000X Nurse Practitioner, Family786779TX

Other names

  • Adeline Asandan (Former Name)

Practice location

3840 Hulen St
Fort Worth, TX 76107-7277

Phone 817-335-3022

Mailing address

Po Box 2603
Fort Worth, TX 76113-2603

Phone 817-569-4039 · Fax 817-810-3042

Other practice locations

855 Montgomery St
Fort Worth, TX 76107-2553

Phone 817-920-7400

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