Provider Demographics
NPI:1174884324
Name:NKENWOUM, SIGOLENE
Entity type:Individual
Prefix:
First Name:SIGOLENE
Middle Name:
Last Name:NKENWOUM
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 1:5802 LUNDY DR
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2349
Mailing Address - Country:US
Mailing Address - Phone:443-652-2535
Mailing Address - Fax:
Practice Address - Street 1:5802 LUNDY DR
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2349
Practice Address - Country:US
Practice Address - Phone:443-652-2535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide