Provider Demographics
NPI:1881371292
Name:SOWAH, WENDY PAMPAM (RN)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:PAMPAM
Last Name:SOWAH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:PAMPAM
Other - Last Name:PREKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4213 WALNEY RD
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-2923
Mailing Address - Country:US
Mailing Address - Phone:703-502-7000
Mailing Address - Fax:
Practice Address - Street 1:4213 WALNEY RD
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-2923
Practice Address - Country:US
Practice Address - Phone:703-502-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA001291688163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health