Healthcare Provider Details

I. General information

NPI: 1306244397
Provider Name (Legal Business Name): MARTINE TCHINDA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3924 MINNESOTA AVE NE
WASHINGTON DC
20019-2661
US

IV. Provider business mailing address

1220 12TH ST SE
WASHINGTON DC
20003-3722
US

V. Phone/Fax

Practice location:
  • Phone: 202-398-8683
  • Fax: 202-548-8600
Mailing address:
  • Phone: 202-715-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR197009
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1024813
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: