Provider Demographics
NPI:1205194453
Name:NKENGANANG, RODOLPHINE
Entity Type:Individual
Prefix:MISS
First Name:RODOLPHINE
Middle Name:
Last Name:NKENGANANG
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 1:9877 GOOD LUCK RD
Mailing Address - Street 2:APT 11
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3205
Mailing Address - Country:US
Mailing Address - Phone:202-446-8417
Mailing Address - Fax:
Practice Address - Street 1:3500 18TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2738
Practice Address - Country:US
Practice Address - Phone:202-529-6510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide