Provider Demographics
NPI:1336504737
Name:NGUM, EMELDA
Entity Type:Individual
Prefix:
First Name:EMELDA
Middle Name:
Last Name:NGUM
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 1:1600 MARYLAND AVE NE APT 224
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-7660
Mailing Address - Country:US
Mailing Address - Phone:240-821-2528
Mailing Address - Fax:
Practice Address - Street 1:1600 MARYLAND AVE NE APT 224
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7660
Practice Address - Country:US
Practice Address - Phone:240-253-3684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-29
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11703374U00000X
DCRN200004430163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide