Provider Demographics
NPI:1396111076
Name:USANGA, UYAI
Entity type:Individual
Prefix:
First Name:UYAI
Middle Name:
Last Name:USANGA
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 1:9825 GOOD LUCK RD
Mailing Address - Street 2:APT. 5
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3364
Mailing Address - Country:US
Mailing Address - Phone:240-551-6289
Mailing Address - Fax:
Practice Address - Street 1:9825 GOOD LUCK RD
Practice Address - Street 2:APT. 5
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3364
Practice Address - Country:US
Practice Address - Phone:240-551-6289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1006168164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse