MEDICARE: KONGIT ABUNUE TKUE

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1083340194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KONGIT ABUNUE TKUE

Provider Business Mailing Address
First Line	:	5601 SEMINARY RD APT 104N
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22041-3506
Country	:	US
Telephone Number	:	703-843-8151
Fax Number	:

Provider Business Practice Location Address
First Line	:	1958 W VIRGINIA AVE NE APT 4
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-1836
Country	:	US
Telephone Number	:	703-843-8151
Fax Number	:

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

Provider Enumeration Date	:	07/29/2022
Last Update Date	:	07/29/2022

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Directions to “ KONGIT ABUNUE TKUE ” Practice Location

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