Healthcare Provider Details

I. General information

NPI: 1629760079
Provider Name (Legal Business Name): MAJOLIE IRENE NJOUONANG EPSE TOGNA ERCKM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11215 OAK LEAF DR APT 1706
SILVER SPRING MD
20901-1379
US

IV. Provider business mailing address

11215 OAK LEAF DR APT 1706
SILVER SPRING MD
20901-1379
US

V. Phone/Fax

Practice location:
  • Phone: 301-328-6750
  • Fax:
Mailing address:
  • Phone: 301-328-6750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number00177727
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: