Provider Demographics
NPI:1578238945
Name:DOBLAH, EVANGELINE NYENPELU
Entity Type:Individual
Prefix:
First Name:EVANGELINE NYENPELU
Middle Name:
Last Name:DOBLAH
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 1:9324 BANDERA ST
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2411
Mailing Address - Country:US
Mailing Address - Phone:240-714-8059
Mailing Address - Fax:
Practice Address - Street 1:9324 BANDERA ST
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2411
Practice Address - Country:US
Practice Address - Phone:240-714-8059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251S00000XAgenciesCommunity/Behavioral Health
No374U00000XNursing Service Related ProvidersHome Health Aide