Provider Demographics
NPI:1316634470
Name:LUMINGU, CATHERINE KOMBOZI
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:KOMBOZI
Last Name:LUMINGU
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 1:6910 ADIOS CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-2510
Mailing Address - Country:US
Mailing Address - Phone:703-981-6417
Mailing Address - Fax:
Practice Address - Street 1:6910 ADIOS CT
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-2510
Practice Address - Country:US
Practice Address - Phone:703-981-6417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374700000XNursing Service Related ProvidersTechnicianGroup - Single Specialty