Healthcare Provider Details

I. General information

NPI: 1063324804
Provider Name (Legal Business Name): GWENDOLINE EPIE NTUNGWE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 GEORGIA AVE NW STE 308
WASHINGTON DC
20012-1616
US

IV. Provider business mailing address

13109 BELLE MEADE TRCE
BOWIE MD
20720-4680
US

V. Phone/Fax

Practice location:
  • Phone: 202-800-9005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN1039729
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: