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General NPI Number Information
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NPI Number | 1306613450
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Entity Type | Individual
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Provider Name | PRISCA KUMA UGWENDUM RN
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Gender | Female
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Dates
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Enumeration Date | 12/08/2023
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 1905 E ST SE # 14
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City | WASHINGTON
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State | DC
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Zip | 20003-2593
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Country | US
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Telephone | 202-673-9319
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Fax |
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Provider Business Mailing Address
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Address Line | 7810 DOGUE INDIAN CIR
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City | LORTON
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State | VA
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Zip | 22079-2145
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Country | US
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Telephone | 571-620-9221
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001299639
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN1063035
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License Number State | DC
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