Provider Demographics
NPI:1407355936
Name:MOUKAM, NKADJI TCHAWE (HHA)
Entity Type:Individual
Prefix:
First Name:NKADJI
Middle Name:TCHAWE
Last Name:MOUKAM
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 1:2101 I ST NE APT 6
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3240
Mailing Address - Country:US
Mailing Address - Phone:202-705-3180
Mailing Address - Fax:
Practice Address - Street 1:2101 I ST NE APT 6
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3240
Practice Address - Country:US
Practice Address - Phone:202-705-3180
Practice Address - Fax:202-705-3180
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-10
Last Update Date:2018-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12978374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide