Provider Demographics
NPI:1558056598
Name:NKOSI, CHARMAINE T
Entity Type:Individual
Prefix:
First Name:CHARMAINE
Middle Name:T
Last Name:NKOSI
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 1:9305 CORPORATE BLVD APT 2122
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5528
Mailing Address - Country:US
Mailing Address - Phone:240-549-0521
Mailing Address - Fax:
Practice Address - Street 1:9305 CORPORATE BLVD APT 2122
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5528
Practice Address - Country:US
Practice Address - Phone:240-549-0521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker