Provider Demographics
NPI:1952666240
Name:LEKE, MISPA AMINKENG
Entity Type:Individual
Prefix:MS
First Name:MISPA
Middle Name:AMINKENG
Last Name:LEKE
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 1:2002 OAKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-4336
Mailing Address - Country:US
Mailing Address - Phone:443-929-9479
Mailing Address - Fax:
Practice Address - Street 1:1628 GOOD HOPE RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4706
Practice Address - Country:US
Practice Address - Phone:202-866-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
DC171M00000X
DCRN1053545163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide
No163W00000XNursing Service ProvidersRegistered Nurse