Provider Demographics
NPI:1376973842
Name:NGEN, BERTHA (HHA)
Entity Type:Individual
Prefix:
First Name:BERTHA
Middle Name:
Last Name:NGEN
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18141 MARKSMAN CIR APT 201
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-3419
Mailing Address - Country:US
Mailing Address - Phone:443-866-5513
Mailing Address - Fax:202-545-0934
Practice Address - Street 1:18141 MARKSMAN CIR APT 201
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-3419
Practice Address - Country:US
Practice Address - Phone:443-866-5513
Practice Address - Fax:202-545-0934
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide