Healthcare Provider Details

I. General information

NPI: 1124688510
Provider Name (Legal Business Name): MAGHA NKARIMBI ELISABETH EPSE COBBI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 COUNTRYWOOD CT
HYATTSVILLE MD
20785-4009
US

IV. Provider business mailing address

1706 COUNTRYWOOD CT
HYATTSVILLE MD
20785-4009
US

V. Phone/Fax

Practice location:
  • Phone: 240-413-2034
  • Fax:
Mailing address:
  • Phone: 240-413-2034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA14441
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: