Provider Demographics
NPI:1033668181
Name:NWALIPENJA, JOSEPHINE
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:NWALIPENJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 VALLEY FORGE DR APT 407
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-5610
Mailing Address - Country:US
Mailing Address - Phone:240-478-0363
Mailing Address - Fax:
Practice Address - Street 1:5250 VALLEY FORGE DR APT 407
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-5610
Practice Address - Country:US
Practice Address - Phone:240-478-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002051664164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse