Provider Demographics
NPI:1487406922
Name:BISSONG, NADEGE NKONGHO
Entity type:Individual
Prefix:
First Name:NADEGE
Middle Name:NKONGHO
Last Name:BISSONG
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 1:5923 CHERRYWOOD TER APT 301
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-4285
Mailing Address - Country:US
Mailing Address - Phone:202-341-8450
Mailing Address - Fax:
Practice Address - Street 1:5923 CHERRYWOOD TER APT 301
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-4285
Practice Address - Country:US
Practice Address - Phone:202-341-8450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant