Provider Demographics
NPI:1033471891
Name:NGOMANJI, JULIET NGUM (NP)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:NGUM
Last Name:NGOMANJI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6602 MANTON WAY
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2489
Mailing Address - Country:US
Mailing Address - Phone:202-520-3689
Mailing Address - Fax:
Practice Address - Street 1:2600 BRYAN PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4417
Practice Address - Country:US
Practice Address - Phone:202-520-3689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP1045959363LP0808X
DCRN1045959163WP0808X
MDR228820363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health