Healthcare Provider Details

I. General information

NPI: 1699646802
Provider Name (Legal Business Name): NOELA KIKWI NJAMANGONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6517 LANDOVER RD APT T2
CHEVERLY MD
20785-1423
US

IV. Provider business mailing address

9889 GOOD LUCK RD
LANHAM MD
20706-3218
US

V. Phone/Fax

Practice location:
  • Phone: 888-793-4357
  • Fax:
Mailing address:
  • Phone: 571-449-3300
  • Fax: 571-699-0540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: