Provider Demographics
NPI:1982390365
Name:MBOGNE SIGNING, JENNY ROSTANT
Entity Type:Individual
Prefix:
First Name:JENNY ROSTANT
Middle Name:
Last Name:MBOGNE SIGNING
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 1:5561 CHILLUM PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-6204
Mailing Address - Country:US
Mailing Address - Phone:202-981-0376
Mailing Address - Fax:
Practice Address - Street 1:5561 CHILLUM PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-6204
Practice Address - Country:US
Practice Address - Phone:202-981-0376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide