Provider Demographics
NPI:1689398703
Name:NJU, QUEENTA ANGUM
Entity Type:Individual
Prefix:
First Name:QUEENTA
Middle Name:ANGUM
Last Name:NJU
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 1:9927 GOOD LUCK RD APT T4
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3257
Mailing Address - Country:US
Mailing Address - Phone:301-541-9413
Mailing Address - Fax:
Practice Address - Street 1:9927 GOOD LUCK RD APT T4
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3257
Practice Address - Country:US
Practice Address - Phone:301-541-9413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200002012374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide