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Individual
MR. EDWIN CHARLES KHONYONGWA
Active
Individual
MR. EDWIN CHARLES KHONYONGWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LALFA, LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002092297
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002092297
LICENSED PRACTICAL NURSE
VA
01
—
1401150271
NURSE AID
VA
01
—
1706001017
ASSISTED LIVING ADMINISTRATOR
VA
01
—
1732000897
NURSING HOME ADMINISTRATOR
VA
Enumeration date
08/28/2020
Last updated
08/28/2020
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