Provider Demographics
NPI:1639541360
Name:GUEMDJO YOUMBI EPSE KOUAM, YVETTE MARIE
Entity Type:Individual
Prefix:
First Name:YVETTE MARIE
Middle Name:
Last Name:GUEMDJO YOUMBI EPSE KOUAM
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 1:5429 56TH AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-2484
Mailing Address - Country:US
Mailing Address - Phone:301-851-1035
Mailing Address - Fax:
Practice Address - Street 1:5429 56TH AVE
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-2484
Practice Address - Country:US
Practice Address - Phone:301-851-1035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide