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General NPI Number Information
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NPI Number | 1447119409
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Entity Type | Individual
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Provider Name | TEBOH RENUS NDAM HHA
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Gender | Male
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 100 M ST SE STE 600
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City | WASHINGTON
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State | DC
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Zip | 20003-3648
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Country | US
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Telephone | 301-613-2064
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Fax |
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Provider Business Mailing Address
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Address Line | 60 HAWAII AVE NE APT 108
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City | WASHINGTON
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State | DC
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Zip | 20011-4937
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Country | US
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Telephone | 267-366-4622
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | HHA200005754
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License Number State | DC
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