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NPI Code Detail

MEDICARE: MISS PAULINA GODFREY KIBANZA

MEDICARE: MISS PAULINA GODFREY KIBANZA
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1518209477
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS PAULINA GODFREY KIBANZA
Provider Business Mailing Address
First Line : 7200 ALDEN WAY APT 2026
Second Line :
City : HANOVER
State : MD
Zip : 21076-2371
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 502 KENNEDY ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-3136
Country : US
Telephone Number : 515-771-0054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2013
Last Update Date : 06/29/2023

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Directions to “ MISS PAULINA GODFREY KIBANZA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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