Provider Demographics
NPI:1578823787
Name:KAMGA, ELISE MOCHE
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:MOCHE
Last Name:KAMGA
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 1:2920 7TH ST NE
Mailing Address - Street 2:APT 4
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-1317
Mailing Address - Country:US
Mailing Address - Phone:502-396-7985
Mailing Address - Fax:
Practice Address - Street 1:2920 7TH ST NE
Practice Address - Street 2:APT 4
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-1317
Practice Address - Country:US
Practice Address - Phone:502-396-7985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide