Provider Demographics
NPI:1174141352
Name:NKEUMEN EPSE TCHIENGA, JULIENNE
Entity type:Individual
Prefix:
First Name:JULIENNE
Middle Name:
Last Name:NKEUMEN EPSE TCHIENGA
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 1:9122 GLENVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-3880
Mailing Address - Country:US
Mailing Address - Phone:240-476-5809
Mailing Address - Fax:
Practice Address - Street 1:3627 HORNER PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2476
Practice Address - Country:US
Practice Address - Phone:240-476-5809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00164519376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide