Healthcare Provider Details

I. General information

NPI: 1780595108
Provider Name (Legal Business Name): NCHANG PAMELA AMBE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3309 DODGE PARK RD
HYATTSVILLE MD
20785-2112
US

IV. Provider business mailing address

3309 DODGE PARK RD
HYATTSVILLE MD
20785-2112
US

V. Phone/Fax

Practice location:
  • Phone: 301-804-8365
  • Fax:
Mailing address:
  • Phone: 301-804-8365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200006889
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: