MEDICARE: CORNELIA OKWEN AMBECK EPSE NJANG

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	172V00000X	Community Health Worker		DC

General Provider Information

NPI Number	:	1659241040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORNELIA OKWEN AMBECK EPSE NJANG

Provider Business Mailing Address
First Line	:	611 DIVISION AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-5457
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 DIVISION AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-5457
Country	:	US
Telephone Number	:	202-204-1361
Fax Number	:

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

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	11/10/2025

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Directions to “ CORNELIA OKWEN AMBECK EPSE NJANG ” Practice Location

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