Provider Demographics
NPI:1285994079
Name:MUGHA, EMMANOELA (HHA)
Entity type:Individual
Prefix:
First Name:EMMANOELA
Middle Name:
Last Name:MUGHA
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1403
Mailing Address - Country:US
Mailing Address - Phone:202-282-3004
Mailing Address - Fax:202-282-2057
Practice Address - Street 1:881 CONCORDE CIR UNIT 32110
Practice Address - Street 2:
Practice Address - City:LINTHICUM HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:21090-2872
Practice Address - Country:US
Practice Address - Phone:240-618-6939
Practice Address - Fax:202-282-2057
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR234525363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1285994079Medicaid