Provider Demographics
NPI:1891053948
Name:NKWENTI, JACQUELINE M
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:M
Last Name:NKWENTI
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 1:9765 GOOD LUCK RD
Mailing Address - Street 2:APT 9
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3331
Mailing Address - Country:US
Mailing Address - Phone:240-274-3317
Mailing Address - Fax:
Practice Address - Street 1:9765 GOOD LUCK RD
Practice Address - Street 2:APT 9
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3331
Practice Address - Country:US
Practice Address - Phone:240-274-3317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide