Provider Demographics
NPI:1942562657
Name:NTEMBE, MADDIE ECHIE
Entity Type:Individual
Prefix:
First Name:MADDIE
Middle Name:ECHIE
Last Name:NTEMBE
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 1:811 FALLS LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3164
Mailing Address - Country:US
Mailing Address - Phone:240-604-0954
Mailing Address - Fax:
Practice Address - Street 1:6423 LANDOVER RD
Practice Address - Street 2:#1021
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1413
Practice Address - Country:US
Practice Address - Phone:240-604-0954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-10
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide