Provider Demographics
NPI:1437412749
Name:KAMGA, LUCIENNE NM
Entity Type:Individual
Prefix:
First Name:LUCIENNE
Middle Name:NM
Last Name:KAMGA
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 1:1906 DANA DR
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-2119
Mailing Address - Country:US
Mailing Address - Phone:301-582-7552
Mailing Address - Fax:
Practice Address - Street 1:1906 DANA DR
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-2119
Practice Address - Country:US
Practice Address - Phone:301-582-7552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide