Provider Demographics
NPI:1487529319
Name:ITUKA, QUEENTA KONGWE
Entity type:Individual
Prefix:
First Name:QUEENTA
Middle Name:KONGWE
Last Name:ITUKA
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 1:7300 QUARTZ TER
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4318
Mailing Address - Country:US
Mailing Address - Phone:240-889-7879
Mailing Address - Fax:
Practice Address - Street 1:7300 QUARTZ TER
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4318
Practice Address - Country:US
Practice Address - Phone:240-889-7879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide