Provider Demographics
NPI:1417596982
Name:NDAPAH EPSE MOSOH, ANETTEE WOPENG
Entity type:Individual
Prefix:
First Name:ANETTEE WOPENG
Middle Name:
Last Name:NDAPAH EPSE MOSOH
Suffix:
Gender:
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 ALLISON ST APT C4
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2039
Mailing Address - Country:US
Mailing Address - Phone:301-364-7408
Mailing Address - Fax:301-364-7408
Practice Address - Street 1:5018 57TH AVE APT A1
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1660
Practice Address - Country:US
Practice Address - Phone:301-364-7408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health Aide