MEDICARE: ELIANE NGWEPNGA

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	374U00000X	Home Health Aide	HHA12379	DC
2	172V00000X	Community Health Worker
3	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1114473287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIANE NGWEPNGA

Provider Business Mailing Address
First Line	:	13302 BLACK DUCK CT
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-7011
Country	:	US
Telephone Number	:	202-848-5413
Fax Number	:

Provider Business Practice Location Address
First Line	:	13302 BLACK DUCK CT
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-7011
Country	:	US
Telephone Number	:	202-848-5413
Fax Number	:

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

Provider Enumeration Date	:	08/29/2016
Last Update Date	:	04/14/2026

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