Provider Demographics
NPI:1689284424
Name:PANKEY, KENYA
Entity Type:Individual
Prefix:
First Name:KENYA
Middle Name:
Last Name:PANKEY
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 1:6507 ROSEMONT ST
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3827
Mailing Address - Country:US
Mailing Address - Phone:301-559-7294
Mailing Address - Fax:
Practice Address - Street 1:4339 BOWEN RD SE APT 202
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5637
Practice Address - Country:US
Practice Address - Phone:202-997-5930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant