MEDICARE: REGINA ANYIKENG RN

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	163W00000X	Registered Nurse	RN1003038	DC
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NP1003038	DC

General Provider Information

NPI Number	:	1154676336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA ANYIKENG RN

Provider Business Mailing Address
First Line	:	7506 GEORGIA AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20012-1608
Country	:	US
Telephone Number	:	202-291-6973
Fax Number	:	202-291-7018

Provider Business Practice Location Address
First Line	:	1427 GOOD HOPE RD SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5614
Country	:	US
Telephone Number	:	202-836-4841
Fax Number	:	202-836-4842

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

Provider Enumeration Date	:	07/13/2012
Last Update Date	:	11/13/2023

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