Healthcare Provider Details

I. General information

NPI: 1336692664
Provider Name (Legal Business Name): VIGING YOUFANG EPSE KOUMPO NGANTCHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4985 COLBURN TER
HYATTSVILLE MD
20782-2345
US

IV. Provider business mailing address

4985 COLBURN TER
HYATTSVILLE MD
20782-2345
US

V. Phone/Fax

Practice location:
  • Phone: 240-615-0183
  • Fax: 202-723-0367
Mailing address:
  • Phone: 240-615-0183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA12223
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: