Provider Demographics
NPI:1477303352
Name:ATANGA, EMMERENSIA
Entity Type:Individual
Prefix:
First Name:EMMERENSIA
Middle Name:
Last Name:ATANGA
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 1:2711 FALLING BROOK TER
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1450
Mailing Address - Country:US
Mailing Address - Phone:302-257-0214
Mailing Address - Fax:
Practice Address - Street 1:2711 FALLING BROOK TER
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-1450
Practice Address - Country:US
Practice Address - Phone:302-257-0214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide