Provider Demographics
NPI:1053926857
Name:NKWAIN, MAGDALENE
Entity type:Individual
Prefix:
First Name:MAGDALENE
Middle Name:
Last Name:NKWAIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 E WEST HWY
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5933
Mailing Address - Country:US
Mailing Address - Phone:202-910-1001
Mailing Address - Fax:
Practice Address - Street 1:963 E WEST HWY
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-5933
Practice Address - Country:US
Practice Address - Phone:202-910-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CNA20202197376K00000X
DCHHA200001762374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide