Provider Demographics
NPI:1194547927
Name:NKIMBENG, JUDE NGANG
Entity type:Individual
Prefix:
First Name:JUDE
Middle Name:NGANG
Last Name:NKIMBENG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 CARA DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5438
Mailing Address - Country:US
Mailing Address - Phone:240-413-1912
Mailing Address - Fax:
Practice Address - Street 1:3605 CARA DR
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:MD
Practice Address - Zip Code:20774-5438
Practice Address - Country:US
Practice Address - Phone:240-413-1912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty