Provider Demographics
NPI:1407665359
Name:KURGAN, NICOLE D (HOME HEALTH AIDE)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:D
Last Name:KURGAN
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 IVERSON ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1508
Mailing Address - Country:US
Mailing Address - Phone:202-455-7309
Mailing Address - Fax:
Practice Address - Street 1:82 I ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-8200
Practice Address - Country:US
Practice Address - Phone:202-826-0671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No374U00000XNursing Service Related ProvidersHome Health Aide