Provider Demographics
NPI:1154070928
Name:NAVOMA, BELTY BOBNYONGA
Entity Type:Individual
Prefix:
First Name:BELTY BOBNYONGA
Middle Name:
Last Name:NAVOMA
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 1:1315 GABES PL
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4322
Mailing Address - Country:US
Mailing Address - Phone:301-541-9476
Mailing Address - Fax:
Practice Address - Street 1:1315 GABES PL
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-4322
Practice Address - Country:US
Practice Address - Phone:301-541-9476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide