Provider Demographics
NPI:1255148649
Name:NDUMBE, MELLISE CLAIRE TONGUE
Entity type:Individual
Prefix:
First Name:MELLISE CLAIRE
Middle Name:TONGUE
Last Name:NDUMBE
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 1:14010 LAKE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3812
Mailing Address - Country:US
Mailing Address - Phone:240-556-8335
Mailing Address - Fax:
Practice Address - Street 1:14010 LAKE MEADOWS DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3812
Practice Address - Country:US
Practice Address - Phone:240-556-8335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide