Healthcare Provider Details

I. General information

NPI: 1245589159
Provider Name (Legal Business Name): VIGILINE NCHONJI NJIMYAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2012
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5902 31ST AVE APT 515
HYATTSVILLE MD
20782-2909
US

IV. Provider business mailing address

5902 31ST AVE APT 515
HYATTSVILLE MD
20782-2909
US

V. Phone/Fax

Practice location:
  • Phone: 240-898-5312
  • Fax:
Mailing address:
  • Phone: 240-898-5312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: