Provider Demographics
NPI:1568030450
Name:NGUEUMOU SABGUEU, PAMELA RAISSA
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:RAISSA
Last Name:NGUEUMOU SABGUEU
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 1:1811 MOUNT PISGAH LN APT 23
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2154
Mailing Address - Country:US
Mailing Address - Phone:206-393-2262
Mailing Address - Fax:
Practice Address - Street 1:1811 MOUNT PISGAH LN APT 23
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2154
Practice Address - Country:US
Practice Address - Phone:206-393-2262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00193286376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide