Healthcare Provider Details

I. General information

NPI: 1427503812
Provider Name (Legal Business Name): CHRISTOPHER NKAMNGO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 SOUTHERN AVE SE APT 301
WASHINGTON DC
20032-4620
US

IV. Provider business mailing address

1234 SOUTHERN AVE SE APT 301
WASHINGTON DC
20032-4620
US

V. Phone/Fax

Practice location:
  • Phone: 202-910-1473
  • Fax:
Mailing address:
  • Phone: 202-910-1473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: