Healthcare Provider Details

I. General information

NPI: 1518559673
Provider Name (Legal Business Name): ROSE FONGE NKIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2021
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8400 DUNBAR AVE
HYATTSVILLE MD
20785-4823
US

IV. Provider business mailing address

8400 DUNBAR AVE
HYATTSVILLE MD
20785-4823
US

V. Phone/Fax

Practice location:
  • Phone: 202-492-2064
  • Fax:
Mailing address:
  • Phone: 202-492-2064
  • 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: