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General NPI Number Information
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NPI Number | 1861974818
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Entity Type | Individual
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Provider Name | SANDRA NZOUNKWELLE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 6918 WILLOW ST NW
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City | WASHINGTON
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State | DC
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Zip | 20012-2197
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Country | US
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Telephone | 301-523-6406
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Fax |
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Provider Business Mailing Address
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Address Line | 14918 4TH ST
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City | LAUREL
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State | MD
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Zip | 20707-3702
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Country | US
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Telephone | 240-838-1285
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 27798
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License Number State | MD
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