Healthcare Provider Details

I. General information

NPI: 1962846428
Provider Name (Legal Business Name): MS. DONNA JANICE NJOKU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2013
Last Update Date: 04/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12624 TROTWOOD CT
BELTSVILLE MD
20705-6304
US

IV. Provider business mailing address

12624 TROTWOOD CT
BELTSVILLE MD
20705-6304
US

V. Phone/Fax

Practice location:
  • Phone: 240-645-9070
  • Fax:
Mailing address:
  • Phone: 240-645-9070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR3322
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: