Provider Demographics
NPI:1336960418
Name:ACHAJENG, WENDOLINE A
Entity type:Individual
Prefix:
First Name:WENDOLINE
Middle Name:A
Last Name:ACHAJENG
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 1:3801 KENILWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-2122
Mailing Address - Country:US
Mailing Address - Phone:240-304-4997
Mailing Address - Fax:
Practice Address - Street 1:3801 KENILWORTH AVE
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-2122
Practice Address - Country:US
Practice Address - Phone:240-304-4997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide