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General NPI Number Information
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NPI Number | 1518509488
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Entity Type | Individual
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Provider Name | CAROLE NGUEKAM NP
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Gender | Female
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Dates
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Enumeration Date | 10/11/2019
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Last Update Date | 03/01/2026
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Provider Practice Location Address
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Address Line | 9276 OLD KEENE MILL RD
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City | BURKE
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State | VA
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Zip | 22015-4201
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Country | US
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Telephone | 571-516-3116
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Fax |
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Provider Business Mailing Address
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Address Line | 804 BONNIE RIDGE DR NE
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City | LEESBURG
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State | VA
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Zip | 20176-3663
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Country | US
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Telephone | 301-266-0828
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R-178652
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License Number State | MD
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