Provider Demographics
NPI:1346505252
Name:NKONGCHU, LINDA EMETAH (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:EMETAH
Last Name:NKONGCHU
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 CEDAR REACH LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-5808
Mailing Address - Country:US
Mailing Address - Phone:240-713-0481
Mailing Address - Fax:
Practice Address - Street 1:2333 ONTARIO RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2627
Practice Address - Country:US
Practice Address - Phone:301-249-8100
Practice Address - Fax:301-390-8086
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR192716363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health