Healthcare Provider Details

I. General information

NPI: 1760308159
Provider Name (Legal Business Name): IDA NGAMENI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 GENTRY LN
CAPITOL HEIGHTS MD
20743-2764
US

IV. Provider business mailing address

11 GENTRY LN
CAPITOL HEIGHTS MD
20743-2764
US

V. Phone/Fax

Practice location:
  • Phone: 240-309-8977
  • Fax:
Mailing address:
  • Phone: 240-309-8977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200006465
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: