MEDICARE: CHRISTELLE VIRGINIA TCHOUNGUIN

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		DC

General Provider Information

NPI Number	:	1396418620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTELLE VIRGINIA TCHOUNGUIN

Provider Business Mailing Address
First Line	:	6604 W FOREST RD APT 201
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-1751
Country	:	US
Telephone Number	:	859-457-3524
Fax Number	:

Provider Business Practice Location Address
First Line	:	6604 W FOREST RD
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-1751
Country	:	US
Telephone Number	:	859-457-3524
Fax Number	:

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

Provider Enumeration Date	:	08/02/2021
Last Update Date	:	08/02/2021

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Directions to “ CHRISTELLE VIRGINIA TCHOUNGUIN ” Practice Location

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