Healthcare Provider Details

I. General information

NPI: 1891051157
Provider Name (Legal Business Name): VICTORIA KINGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 MARTIN LUTHER KING JR AVE SW STE A2
WASHINGTON DC
20032-4933
US

IV. Provider business mailing address

11540 WAESCHE DR
BOWIE MD
20721-2268
US

V. Phone/Fax

Practice location:
  • Phone: 202-318-0179
  • Fax:
Mailing address:
  • Phone: 202-367-0782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN1008478
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: