Provider Demographics
NPI:1295099828
Name:TSOPMO, CELINE NADINE KENZANG
Entity type:Individual
Prefix:
First Name:CELINE
Middle Name:NADINE KENZANG
Last Name:TSOPMO
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 1:11302 EVAS TRAIL
Mailing Address - Street 2:201
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705
Mailing Address - Country:US
Mailing Address - Phone:240-429-2236
Mailing Address - Fax:
Practice Address - Street 1:11302 EVANS TRL
Practice Address - Street 2:201
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3003
Practice Address - Country:US
Practice Address - Phone:240-429-2236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide