Provider Demographics
NPI:1295220630
Name:TANGYE ATEMBA, YVONNE (LPN, CNA)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:TANGYE ATEMBA
Suffix:
Gender:F
Credentials:LPN, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 BUNKER HILL RD NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-3026
Mailing Address - Country:US
Mailing Address - Phone:202-635-5756
Mailing Address - Fax:202-635-5780
Practice Address - Street 1:10728 WILLOW OAKS DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2757
Practice Address - Country:US
Practice Address - Phone:240-505-4503
Practice Address - Fax:202-635-5780
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1008558164W00000X
MDA00129430374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No164W00000XNursing Service ProvidersLicensed Practical Nurse