Provider Demographics
NPI:1700372372
Name:NYAGAH, SOLANGE IYUNJEI SR (HHA)
Entity Type:Individual
Prefix:MRS
First Name:SOLANGE
Middle Name:IYUNJEI
Last Name:NYAGAH
Suffix:SR
Gender:F
Credentials:HHA
Other - Prefix:MRS
Other - First Name:SOLANGE
Other - Middle Name:IYUNJE
Other - Last Name:NYAGAH
Other - Suffix:SR
Other - Last Name Type:Other Name
Other - Credentials:HHA
Mailing Address - Street 1:5811 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2921
Mailing Address - Country:US
Mailing Address - Phone:240-501-2256
Mailing Address - Fax:
Practice Address - Street 1:5811 84TH AVE
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-2921
Practice Address - Country:US
Practice Address - Phone:240-501-2256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-07
Last Update Date:2018-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHHA13743374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide