Provider Demographics
NPI:1285071878
Name:YOUMBI, EMILE CHEUYOU
Entity type:Individual
Prefix:
First Name:EMILE
Middle Name:CHEUYOU
Last Name:YOUMBI
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 1:11312 EVANS TRL APT 202
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3008
Mailing Address - Country:US
Mailing Address - Phone:240-432-3953
Mailing Address - Fax:
Practice Address - Street 1:4920 NIAGARA RD STE 318-320
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-1110
Practice Address - Country:US
Practice Address - Phone:301-982-6477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDCDOH06000117144164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse