Provider Demographics
NPI:1689923963
Name:NGUEFACK, MARIE PASCALE
Entity Type:Individual
Prefix:MISS
First Name:MARIE
Middle Name:PASCALE
Last Name:NGUEFACK
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 1:1020 QUEBEC TER
Mailing Address - Street 2:APT. 303
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-3125
Mailing Address - Country:US
Mailing Address - Phone:301-915-5154
Mailing Address - Fax:
Practice Address - Street 1:1020 QUEBEC TER
Practice Address - Street 2:APT. 303
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-3125
Practice Address - Country:US
Practice Address - Phone:301-915-5154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-03
Last Update Date:2012-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide