Provider Demographics
NPI:1417217662
Name:NNAMOKO, CHINENYE ANGELA (LPN)
Entity Type:Individual
Prefix:MS
First Name:CHINENYE
Middle Name:ANGELA
Last Name:NNAMOKO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11315 KETTERING CIR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1675
Mailing Address - Country:US
Mailing Address - Phone:301-324-1481
Mailing Address - Fax:
Practice Address - Street 1:11315 KETTERING CIR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1675
Practice Address - Country:US
Practice Address - Phone:301-324-1481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1006053164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse