MEDICARE: JOSEPHINE NWALIPENJA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	0002051664	VA

General Provider Information

NPI Number	:	1033668181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPHINE NWALIPENJA

Provider Business Mailing Address
First Line	:	5250 VALLEY FORGE DR APT 407
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-5610
Country	:	US
Telephone Number	:	240-478-0363
Fax Number	:

Provider Business Practice Location Address
First Line	:	5250 VALLEY FORGE DR APT 407
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-5610
Country	:	US
Telephone Number	:	240-478-0363
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2016
Last Update Date	:	09/30/2016

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Directions to “ JOSEPHINE NWALIPENJA ” Practice Location

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