Individual provider · Type 1 NPI
Alimata Sore Ouedraogo, APN
Psychiatric/Mental Health Nurse Practitioner · Jersey City, NJ
NPI number
1639778301
Active
Practice location
176 Palisade Ave
Jersey City, NJ 07306
Mailing address
2333 Morris Ave Ste C202
Union, NJ 07083-5747
Other practice locations
- 550 Broad St Ste 606, Newark, NJ 07102-4537 · (201) 822-1161
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 26NJ01068900 (NJ) |
| Psychiatry Physician | 2084P0800X | 26NJ01068900 (NJ) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1639778301
Alimata Sore Ouedraogo, APN's National Provider Identifier is 1639778301, issued on Oct 22, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Jersey City, NJ. The record was last updated on Aug 13, 2026.