Provider Demographics
NPI:1013451053
Name:BEMPONG, JANET (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:
Last Name:BEMPONG
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9607 MCWHORTER FARM CT
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-3302
Mailing Address - Country:US
Mailing Address - Phone:240-505-1553
Mailing Address - Fax:301-414-5468
Practice Address - Street 1:9607 MCWHORTER FARM CT
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:MD
Practice Address - Zip Code:20872-3302
Practice Address - Country:US
Practice Address - Phone:240-505-1553
Practice Address - Fax:301-414-5468
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3759R3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5423597500Medicaid