Provider Demographics
NPI:1417507203
Name:BALINGWE, NELSON NGWA
Entity Type:Individual
Prefix:MR
First Name:NELSON
Middle Name:NGWA
Last Name:BALINGWE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3341 BENNING RD NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-1502
Mailing Address - Country:US
Mailing Address - Phone:202-758-9347
Mailing Address - Fax:202-543-2758
Practice Address - Street 1:3341 BENNING RD NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1502
Practice Address - Country:US
Practice Address - Phone:202-758-9347
Practice Address - Fax:202-543-2758
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1049231163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty