Provider Demographics
NPI:1922441179
Name:ROSALINE, NGUEMGNE
Entity Type:Individual
Prefix:MISS
First Name:NGUEMGNE
Middle Name:
Last Name:ROSALINE
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 1:14205 WEEPING WILLOW DR APT 23
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2550
Mailing Address - Country:US
Mailing Address - Phone:240-426-1624
Mailing Address - Fax:
Practice Address - Street 1:14205 WEEPING WILLOW DR APT 23
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2550
Practice Address - Country:US
Practice Address - Phone:240-426-1624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA0520251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health