Healthcare Provider Details

I. General information

NPI: 1982504742
Provider Name (Legal Business Name): PRUDENCIA NKFUNJI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2026
Last Update Date: 11/06/2026
Certification Date: 11/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9767 GOOD LUCK RD APT 2
LANHAM MD
20706-3332
US

IV. Provider business mailing address

9767 GOOD LUCK RD APT 2
LANHAM MD
20706-3332
US

V. Phone/Fax

Practice location:
  • Phone: 240-968-5978
  • Fax:
Mailing address:
  • Phone: 240-968-5978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200007009
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: