Provider Demographics
NPI:1659713089
Name:MBENG, NATHALIE AYUK
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:AYUK
Last Name:MBENG
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 1:11215 OAK LEAF DR
Mailing Address - Street 2:APT 1519
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1317
Mailing Address - Country:US
Mailing Address - Phone:301-357-3789
Mailing Address - Fax:
Practice Address - Street 1:11215 OAK LEAF DR
Practice Address - Street 2:APT 1519
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1317
Practice Address - Country:US
Practice Address - Phone:301-357-3789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2023-07-20
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