Healthcare Provider Details

I. General information

NPI: 1053215780
Provider Name (Legal Business Name): FNU BRIDGET YEMBE TANKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7863 RIVERDALE RD APT 202
NEW CARROLLTON MD
20784-4032
US

IV. Provider business mailing address

7863 RIVERDALE RD APT 202
NEW CARROLLTON MD
20784-4032
US

V. Phone/Fax

Practice location:
  • Phone: 240-606-1726
  • Fax:
Mailing address:
  • Phone: 240-606-1726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: