Provider Demographics
NPI:1710373071
Name:NSANG, SOLANGE
Entity Type:Individual
Prefix:
First Name:SOLANGE
Middle Name:
Last Name:NSANG
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 1:1121 ANDEAN GOOSE WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-7131
Mailing Address - Country:US
Mailing Address - Phone:281-865-0966
Mailing Address - Fax:
Practice Address - Street 1:1121 ANDEAN GOOSE WAY
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-7131
Practice Address - Country:US
Practice Address - Phone:281-865-0966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC11093374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide