Provider Demographics
NPI:1467229534
Name:NKWANG, EMELINE VUNYUI
Entity Type:Individual
Prefix:
First Name:EMELINE
Middle Name:VUNYUI
Last Name:NKWANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VUNYUI
Other - Middle Name:
Other - Last Name:EMELINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4812 LAKE ONTARIO WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3695
Mailing Address - Country:US
Mailing Address - Phone:310-237-8895
Mailing Address - Fax:
Practice Address - Street 1:50 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-745-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP500014804363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health