Provider Demographics
NPI:1053122143
Name:NDI, QUEENACOR NCHANG (QN)
Entity type:Individual
Prefix:MRS
First Name:QUEENACOR
Middle Name:NCHANG
Last Name:NDI
Suffix:
Gender:F
Credentials:QN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9945 GOOD LUCK RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3265
Mailing Address - Country:US
Mailing Address - Phone:202-893-4384
Mailing Address - Fax:
Practice Address - Street 1:9945 GOOD LUCK RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3265
Practice Address - Country:US
Practice Address - Phone:202-893-4384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC200004396374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide