Provider Demographics
NPI:1588906853
Name:LUMANKAA, VICTORINE (HHA)
Entity type:Individual
Prefix:
First Name:VICTORINE
Middle Name:
Last Name:LUMANKAA
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 CALVERTON BLVD
Mailing Address - Street 2:APT 11
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3406
Mailing Address - Country:US
Mailing Address - Phone:240-602-9042
Mailing Address - Fax:
Practice Address - Street 1:3800 CALVERTON BLVD
Practice Address - Street 2:APT 11
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3406
Practice Address - Country:US
Practice Address - Phone:240-602-9042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1393374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide