Provider Demographics
NPI:1629337621
Name:NJANJOUO KEMENI, MERLINE
Entity Type:Individual
Prefix:
First Name:MERLINE
Middle Name:
Last Name:NJANJOUO KEMENI
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 1:417 W DIAMOND AVE
Mailing Address - Street 2:APT 302
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2126
Mailing Address - Country:US
Mailing Address - Phone:240-374-3359
Mailing Address - Fax:
Practice Address - Street 1:417 W DIAMOND AVE
Practice Address - Street 2:APT 302
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2126
Practice Address - Country:US
Practice Address - Phone:240-374-3359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDN252599018628374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide