MEDICARE: GUYLENE DJIDJOU DJAHOUNG TEMKENG

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	163W00000X	Registered Nurse	RN1059368	DC

General Provider Information

NPI Number	:	1831510940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUYLENE DJIDJOU DJAHOUNG TEMKENG

Provider Business Mailing Address
First Line	:	908 LAKE FRONT DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20721-2950
Country	:	US
Telephone Number	:	240-467-8037
Fax Number	:

Provider Business Practice Location Address
First Line	:	908 LAKE FRONT DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20721-2950
Country	:	US
Telephone Number	:	240-467-8037
Fax Number	:

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

Provider Enumeration Date	:	12/17/2013
Last Update Date	:	08/30/2023

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