Provider Demographics
NPI:1053912816
Name:NJONG, MAGDALEINE ANGUM
Entity type:Individual
Prefix:
First Name:MAGDALEINE
Middle Name:ANGUM
Last Name:NJONG
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 1:620 SHERIDAN ST APT 410
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3207
Mailing Address - Country:US
Mailing Address - Phone:301-755-4621
Mailing Address - Fax:
Practice Address - Street 1:620 SHERIDAN ST APT 410
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3207
Practice Address - Country:US
Practice Address - Phone:301-755-4621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide