Provider Demographics
NPI:1255204459
Name:NDJOUSSI, HURLERE VIRGINE (NP)
Entity type:Individual
Prefix:
First Name:HURLERE
Middle Name:VIRGINE
Last Name:NDJOUSSI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11273 SUFFOLK DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-4054
Mailing Address - Country:US
Mailing Address - Phone:240-437-2133
Mailing Address - Fax:
Practice Address - Street 1:3611 BRANCH AVE STE 404
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1251
Practice Address - Country:US
Practice Address - Phone:301-337-9642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2378132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry