Provider Demographics
NPI:1568972487
Name:MEUDJEUMI, FLAVIENNE NDONWOU
Entity Type:Individual
Prefix:
First Name:FLAVIENNE
Middle Name:NDONWOU
Last Name:MEUDJEUMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FLAVIENNE
Other - Middle Name:C
Other - Last Name:MEUDJEUMI NDONWOU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13836 CASTLE BLVD APT 103
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7374
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13836 CASTLE BLVD APT 103
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7374
Practice Address - Country:US
Practice Address - Phone:301-792-6871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13155374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide