Provider Demographics
NPI:1568722635
Name:ATEM, SUSAN NKENG
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:NKENG
Last Name:ATEM
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 1:10002 TREETOP LN
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2117
Mailing Address - Country:US
Mailing Address - Phone:240-476-9574
Mailing Address - Fax:
Practice Address - Street 1:10002 TREETOP LN
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2117
Practice Address - Country:US
Practice Address - Phone:240-476-9574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide