MEDICARE: MICHELE BEKU U NKANGNO

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	HHA12115	DC

General Provider Information

NPI Number	:	1255780813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE BEKU U NKANGNO

Provider Business Mailing Address
First Line	:	P O BOX:649
Second Line	:
City	:	BAFOUSSAM
State	:	OUEST
Zip	:	649
Country	:	CM
Telephone Number	:	240-264-7946
Fax Number	:

Provider Business Practice Location Address
First Line	:	2015 AVALON PL
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20783-2811
Country	:	US
Telephone Number	:	240-264-7946
Fax Number	:

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

Provider Enumeration Date	:	06/05/2016
Last Update Date	:	06/05/2016

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Directions to “ MICHELE BEKU U NKANGNO ” Practice Location

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