Provider Demographics
NPI:1497416036
Name:NGAKO, DIVINE DAMKAM CHRISTELLE
Entity Type:Individual
Prefix:
First Name:DIVINE
Middle Name:DAMKAM CHRISTELLE
Last Name:NGAKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DIVINE
Other - Middle Name:DAMKAM CHRISTELLE
Other - Last Name:NGAKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2703 MILLWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2989
Mailing Address - Country:US
Mailing Address - Phone:240-707-4039
Mailing Address - Fax:
Practice Address - Street 1:2703 MILLWOOD WAY
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2989
Practice Address - Country:US
Practice Address - Phone:240-707-4039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion