Provider Demographics
NPI:1295557924
Name:NDOBOUO, JULIENNE FELIXINE
Entity type:Individual
Prefix:
First Name:JULIENNE
Middle Name:FELIXINE
Last Name:NDOBOUO
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 1:3401 HAMPTON HOLLOW DR
Mailing Address - Street 2:APT H
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904
Mailing Address - Country:US
Mailing Address - Phone:202-509-4196
Mailing Address - Fax:
Practice Address - Street 1:3401 HAMPTON HOLLOW DR
Practice Address - Street 2:APT H
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904
Practice Address - Country:US
Practice Address - Phone:202-509-4196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide