Provider Demographics
NPI:1881358224
Name:KACHINGWE, NASSORO
Entity type:Individual
Prefix:
First Name:NASSORO
Middle Name:
Last Name:KACHINGWE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5042 38TH AVE APT 23
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3923
Mailing Address - Country:US
Mailing Address - Phone:240-701-6170
Mailing Address - Fax:
Practice Address - Street 1:5042 38TH AVE APT 23
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3923
Practice Address - Country:US
Practice Address - Phone:240-701-6170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA2000022303374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide