MEDICARE: PATIENCE NKENG

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	HHA12726	DC

General Provider Information

NPI Number	:	1639691785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATIENCE NKENG

Provider Business Mailing Address
First Line	:	7401 NEW HAMPSHIRE AVE APT 1014
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-6955
Country	:	US
Telephone Number	:	240-423-4810
Fax Number	:

Provider Business Practice Location Address
First Line	:	7401 NEW HAMPSHIRE AVE APT 1014
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-6955
Country	:	US
Telephone Number	:	240-423-4810
Fax Number	:

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

Provider Enumeration Date	:	07/11/2017
Last Update Date	:	07/21/2022

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