Provider Demographics
NPI:1023434651
Name:NKAFU, COLLINS A
Entity type:Individual
Prefix:
First Name:COLLINS
Middle Name:A
Last Name:NKAFU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9759 GOODLUCK RD
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:MD
Mailing Address - Zip Code:20706
Mailing Address - Country:US
Mailing Address - Phone:240-413-9450
Mailing Address - Fax:
Practice Address - Street 1:9759 GOODLUCK RD
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:MD
Practice Address - Zip Code:20706
Practice Address - Country:US
Practice Address - Phone:240-413-9450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-06
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide