Provider Demographics
NPI:1609366244
Name:NGOKOU, FLAVINE UGUETTE
Entity Type:Individual
Prefix:
First Name:FLAVINE
Middle Name:UGUETTE
Last Name:NGOKOU
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 1:11362 EVANS TRL APT 101
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3032
Mailing Address - Country:US
Mailing Address - Phone:301-326-7284
Mailing Address - Fax:
Practice Address - Street 1:1809 MOUNT PISGAH LN
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2152
Practice Address - Country:US
Practice Address - Phone:202-415-7992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13686374U00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCHHA13686OtherAPPLYING FOR SELF