Healthcare Provider Details

I. General information

NPI: 1427953660
Provider Name (Legal Business Name): CHRISTELLE KUKAPA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 CORPORATE DR STE 120
LANDOVER MD
20785-2413
US

IV. Provider business mailing address

8300 CORPORATE DR STE 120
LANDOVER MD
20785-2413
US

V. Phone/Fax

Practice location:
  • Phone: 301-249-4333
  • Fax:
Mailing address:
  • Phone: 301-249-4333
  • Fax: 301-576-3631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR245784
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: