Provider Demographics
NPI:1528893302
Name:NGUEKAM MONKAM, ANTOINETTE RAISSA
Entity type:Individual
Prefix:
First Name:ANTOINETTE RAISSA
Middle Name:
Last Name:NGUEKAM MONKAM
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 1:12433 LOFT LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6604
Mailing Address - Country:US
Mailing Address - Phone:240-571-1937
Mailing Address - Fax:
Practice Address - Street 1:21 FEATHERWOOD CT APT 34
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7621
Practice Address - Country:US
Practice Address - Phone:240-571-1937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide