Provider Demographics
NPI:1073263406
Name:NGAMENI MOUANI, ARIELLE CYRELLE (MD)
Entity type:Individual
Prefix:
First Name:ARIELLE CYRELLE
Middle Name:
Last Name:NGAMENI MOUANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 N COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-3920
Mailing Address - Country:US
Mailing Address - Phone:580-220-6836
Mailing Address - Fax:
Practice Address - Street 1:1020 N COMMERCE ST
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-3920
Practice Address - Country:US
Practice Address - Phone:580-220-6836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEBS7349827207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine