Provider Demographics
NPI:1548508278
Name:CHI, HILDA MUNGEN (NP)
Entity type:Individual
Prefix:
First Name:HILDA
Middle Name:MUNGEN
Last Name:CHI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5475 SAINT RITA DR
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3277
Mailing Address - Country:US
Mailing Address - Phone:240-476-5557
Mailing Address - Fax:
Practice Address - Street 1:5475 SAINT RITA DR
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3277
Practice Address - Country:US
Practice Address - Phone:240-476-5557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207734363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily