Provider Demographics
NPI:1952079113
Name:TCHOUNOU NGANA, PELAGIE MICHOUR
Entity Type:Individual
Prefix:
First Name:PELAGIE MICHOUR
Middle Name:
Last Name:TCHOUNOU NGANA
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 1:2012 MARYLAND AVE NE APT 105
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3116
Mailing Address - Country:US
Mailing Address - Phone:202-867-4986
Mailing Address - Fax:
Practice Address - Street 1:2012 MARYLAND AVE NE APT 105
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3116
Practice Address - Country:US
Practice Address - Phone:202-867-4986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide