Provider Demographics
NPI:1265072334
Name:EPSE MOKAM, PIERRETTE THERESE KUENDEU
Entity type:Individual
Prefix:
First Name:PIERRETTE THERESE
Middle Name:KUENDEU
Last Name:EPSE MOKAM
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 1:2611 RICHMOND HWY STE 700
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-4016
Mailing Address - Country:US
Mailing Address - Phone:844-381-4432
Mailing Address - Fax:855-436-9066
Practice Address - Street 1:1010 VERMONT AVE NW STE 1003
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4927
Practice Address - Country:US
Practice Address - Phone:844-381-4432
Practice Address - Fax:855-436-9066
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty