MEDICARE: EVELYN NGWINI HHA

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	R235284	MD

General Provider Information

NPI Number	:	1154681088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELYN NGWINI HHA

Provider Business Mailing Address
First Line	:	21600 RIDGEDALE ST
Second Line	:
City	:	OAK PARK
State	:	MI
Zip	:	48237-2726
Country	:	US
Telephone Number	:	301-549-9062
Fax Number	:

Provider Business Practice Location Address
First Line	:	14460 OLD MILL RD STE 201
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-3092
Country	:	US
Telephone Number	:	202-282-3004
Fax Number	:	202-282-2057

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

Provider Enumeration Date	:	05/25/2012
Last Update Date	:	02/24/2026

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