Provider Demographics
NPI:1518527282
Name:NKENGFAC, KATHI
Entity Type:Individual
Prefix:
First Name:KATHI
Middle Name:
Last Name:NKENGFAC
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 1:143 KENNEDY ST NW STE 16
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5268
Mailing Address - Country:US
Mailing Address - Phone:202-507-8139
Mailing Address - Fax:
Practice Address - Street 1:143 KENNEDY ST NW STE 16
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5268
Practice Address - Country:US
Practice Address - Phone:202-507-8139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-15
Last Update Date:2019-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRRN1052655163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management