Provider Demographics
NPI:1801157664
Name:JOKO, APOLLINE AWGWE
Entity type:Individual
Prefix:
First Name:APOLLINE
Middle Name:AWGWE
Last Name:JOKO
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 1:13107 SERPENTINE WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5338
Mailing Address - Country:US
Mailing Address - Phone:404-952-8071
Mailing Address - Fax:
Practice Address - Street 1:13107 SERPENTINE WAY
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5338
Practice Address - Country:US
Practice Address - Phone:404-952-8071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDJ200069067106374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide