Provider Demographics
NPI:1306633144
Name:MULONDA, PATRICK KIFOKIE
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:KIFOKIE
Last Name:MULONDA
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 1:105 ROLLING BROOK RD
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:ME
Mailing Address - Zip Code:04071-6781
Mailing Address - Country:US
Mailing Address - Phone:207-870-7206
Mailing Address - Fax:
Practice Address - Street 1:105 ROLLING BROOK RD
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:ME
Practice Address - Zip Code:04071-6781
Practice Address - Country:US
Practice Address - Phone:207-870-7206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide