Provider Demographics
NPI:1952648685
Name:LUCY NJOKA MBAH, XXX
Entity Type:Individual
Prefix:
First Name:XXX
Middle Name:
Last Name:LUCY NJOKA MBAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LUCY
Other - Middle Name:MBAHEPSECHUT
Other - Last Name:NJOKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8028 ALLOYWAY LANE
Mailing Address - Street 2:
Mailing Address - City:BETSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705
Mailing Address - Country:US
Mailing Address - Phone:240-779-1885
Mailing Address - Fax:
Practice Address - Street 1:8028 ALLOYWAY LANE
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705
Practice Address - Country:US
Practice Address - Phone:240-779-1885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide