Provider Demographics
NPI:1114749819
Name:NGO YEBGA, GISELE RAPHAELLE
Entity type:Individual
Prefix:
First Name:GISELE
Middle Name:RAPHAELLE
Last Name:NGO YEBGA
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 1:9727 MOUNT PISGAH RD APT 804
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2011
Mailing Address - Country:US
Mailing Address - Phone:701-409-5488
Mailing Address - Fax:
Practice Address - Street 1:9727 MOUNT PISGAH RD APT 804
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2011
Practice Address - Country:US
Practice Address - Phone:701-409-5488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200003872374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide