Provider Demographics
NPI:1184052961
Name:NKEMGANG, CARINE
Entity type:Individual
Prefix:
First Name:CARINE
Middle Name:
Last Name:NKEMGANG
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 1:4804 LAKEVIEW LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4247
Mailing Address - Country:US
Mailing Address - Phone:301-979-5411
Mailing Address - Fax:
Practice Address - Street 1:4804 LAKEVIEW LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4247
Practice Address - Country:US
Practice Address - Phone:301-979-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-14
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA9724374U00000X
DCRN1056940163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide