Healthcare Provider Details

I. General information

NPI: 1013820703
Provider Name (Legal Business Name): PASCALINE KOUAMEGUI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 PRINCE PHILIP DR
OLNEY MD
20832-1514
US

IV. Provider business mailing address

10903 DRESDEN DR
BELTSVILLE MD
20705-2838
US

V. Phone/Fax

Practice location:
  • Phone: 301-774-8882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP500004578
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR242371
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: