Healthcare Provider Details

I. General information

NPI: 1710691126
Provider Name (Legal Business Name): NKWANMANJI DERICK NJUAPIEKEH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2023
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2713 ROBINSON PL SE APT 103
WASHINGTON DC
20020-8018
US

IV. Provider business mailing address

5351 NEWTON ST APT T
HYATTSVILLE MD
20784-1013
US

V. Phone/Fax

Practice location:
  • Phone: 202-893-2459
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200003158
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: