Provider Demographics
NPI:1417596982
Name:NDAPAH EPSE MOSOH, ANETTE WOPENG
Entity Type:Individual
Prefix:
First Name:ANETTE WOPENG
Middle Name:
Last Name:NDAPAH EPSE MOSOH
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 1:5018 57TH AVE APT A1
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1660
Mailing Address - Country:US
Mailing Address - Phone:301-364-7408
Mailing Address - Fax:
Practice Address - Street 1:5018 57TH AVE APT A1
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1660
Practice Address - Country:US
Practice Address - Phone:301-364-7408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide