MEDICARE: MRS. JANET BEMPONG RN, BSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant	R3759R	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013451053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANET BEMPONG RN, BSN

Provider Business Mailing Address
First Line	:	9607 MCWHORTER FARM CT
Second Line	:
City	:	DAMASCUS
State	:	MD
Zip	:	20872-3302
Country	:	US
Telephone Number	:	240-505-1553
Fax Number	:	301-414-5468

Provider Business Practice Location Address
First Line	:	9607 MCWHORTER FARM CT
Second Line	:
City	:	DAMASCUS
State	:	MD
Zip	:	20872-3302
Country	:	US
Telephone Number	:	240-505-1553
Fax Number	:	301-414-5468

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2016
Last Update Date	:	12/09/2016

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