Provider Demographics
NPI:1770369688
Name:NKWENTI, MARCELINE LUM (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MARCELINE
Middle Name:LUM
Last Name:NKWENTI
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:MARCELINE
Other - Middle Name:LUM
Other - Last Name:NKWENTI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:9322 STEEPLE CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-5825
Mailing Address - Country:US
Mailing Address - Phone:301-642-6060
Mailing Address - Fax:
Practice Address - Street 1:9322 STEEPLE CT
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-5825
Practice Address - Country:US
Practice Address - Phone:301-642-6060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR206386163WP0807X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent