Provider Demographics
NPI:1295502730
Name:NWEBONGCHEGE, JUDE BOEYEO
Entity type:Individual
Prefix:
First Name:JUDE
Middle Name:BOEYEO
Last Name:NWEBONGCHEGE
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 1:306 EVARTS ST NE APT 204
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1052
Mailing Address - Country:US
Mailing Address - Phone:202-439-9917
Mailing Address - Fax:
Practice Address - Street 1:306 EVARTS ST NE APT 204
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1052
Practice Address - Country:US
Practice Address - Phone:202-439-9917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200003358374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide