Healthcare Provider Details

I. General information

NPI: 1306511514
Provider Name (Legal Business Name): THERSIA NYAMBI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9867 GOOD LUCK RD
LANHAM MD
20706-3208
US

IV. Provider business mailing address

9867 GOOD LUCK RD
LANHAM MD
20706-3208
US

V. Phone/Fax

Practice location:
  • Phone: 202-880-4784
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200001215
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: