Individual
ETIENDEM NKENGAFAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9814 PHEASANT RUN CT, LAUREL, MD 20708-3192
(240) 232-9199
Mailing address
9814 PHEASANT RUN CT, LAUREL, MD 20708-3192
(240) 232-9199
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
05/16/2025
Last updated
05/16/2025
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