MEDICARE: MIRABEL A NYANGDONG

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	:	1578401683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRABEL A NYANGDONG

Provider Business Mailing Address
First Line	:	6301 GRENFELL CT
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-5331
Country	:	US
Telephone Number	:	240-923-6889
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 GRENFELL CT
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-5331
Country	:	US
Telephone Number	:	240-923-6889
Fax Number	:

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

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ MIRABEL A NYANGDONG ” Practice Location

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