Provider Demographics
NPI:1881955334
Name:KACHINGWE, MARIAM Y
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:Y
Last Name:KACHINGWE
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 1:3205 QUEENSTOWN DR
Mailing Address - Street 2:APT.# 303
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1064
Mailing Address - Country:US
Mailing Address - Phone:240-264-0945
Mailing Address - Fax:
Practice Address - Street 1:3205 QUEENSTOWN DR
Practice Address - Street 2:APT.# 303
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-1064
Practice Address - Country:US
Practice Address - Phone:240-264-0945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide