Healthcare Provider Details

I. General information

NPI: 1134755515
Provider Name (Legal Business Name): CONCILIA NKEMBUH NANA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2020
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 13TH ST NW APT 323
WASHINGTON DC
20011-3564
US

IV. Provider business mailing address

5601 13TH ST NW APT 323
WASHINGTON DC
20011-3564
US

V. Phone/Fax

Practice location:
  • Phone: 202-598-1520
  • Fax:
Mailing address:
  • Phone: 202-598-1520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: