Provider Demographics
NPI:1427567437
Name:NKWENJE, KHADIZA NJECHAB
Entity type:Individual
Prefix:
First Name:KHADIZA
Middle Name:NJECHAB
Last Name:NKWENJE
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 1:1303 GUNPOWDER CT
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4147
Mailing Address - Country:US
Mailing Address - Phone:240-660-8636
Mailing Address - Fax:
Practice Address - Street 1:1303 GUNPOWDER CT
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4147
Practice Address - Country:US
Practice Address - Phone:240-660-8636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
DCHHA12879374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide