Provider Demographics
NPI:1477223527
Name:NJIFOR, IGNATIUS ATEMNKENG
Entity Type:Individual
Prefix:
First Name:IGNATIUS
Middle Name:ATEMNKENG
Last Name:NJIFOR
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 1:5603 JOYCE PL
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1645
Mailing Address - Country:US
Mailing Address - Phone:240-495-8683
Mailing Address - Fax:
Practice Address - Street 1:5603 JOYCE PL
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1645
Practice Address - Country:US
Practice Address - Phone:240-495-8683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-19
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00197650376K00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA00197650Medicaid