Provider Demographics
NPI:1740548874
Name:NANKENG, NANFACK E
Entity type:Individual
Prefix:
First Name:NANFACK
Middle Name:E
Last Name:NANKENG
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 1:6735 NEW HAMPSHIRE AVE
Mailing Address - Street 2:1102
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4865
Mailing Address - Country:US
Mailing Address - Phone:240-237-6337
Mailing Address - Fax:
Practice Address - Street 1:6735 NEW HAMPSHIRE AVE
Practice Address - Street 2:1102
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4865
Practice Address - Country:US
Practice Address - Phone:240-237-6337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide