MEDICARE: NKONGHO JEMIMA EBOT

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1912841800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NKONGHO JEMIMA EBOT

Provider Business Mailing Address
First Line	:	6525 LANDOVER RD
Second Line	:
City	:	CHEVERLY
State	:	MD
Zip	:	20785-1427
Country	:	US
Telephone Number	:	301-409-2543
Fax Number	:

Provider Business Practice Location Address
First Line	:	6525 LANDOVER RD APT 103
Second Line	:
City	:	CHEVERLY
State	:	MD
Zip	:	20785-1427
Country	:	US
Telephone Number	:	301-409-2543
Fax Number	:

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

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	06/01/2026

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Directions to “ NKONGHO JEMIMA EBOT ” Practice Location

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