Provider Demographics
NPI:1386189199
Name:LEKUNGA, ANNE
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:LEKUNGA
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 1:5021 TOWNSEND WAY
Mailing Address - Street 2:A2
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1828
Mailing Address - Country:US
Mailing Address - Phone:240-708-1606
Mailing Address - Fax:
Practice Address - Street 1:5021 TOWNSEND WAY
Practice Address - Street 2:A2
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1828
Practice Address - Country:US
Practice Address - Phone:240-708-1606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12540374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide