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Individual

KEVINE DJUIMTSOP MBALALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2010 RHODE ISLAND AVE NE, WASHINGTON, DC 20018-2835
(240) 616-8092
Mailing address
7010 WEST PARK DR, HYATTSVILLE, MD 20783
(240) 821-3421

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
500016824
DC

Other

Enumeration date
09/07/2017
Last updated
11/11/2025
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