Provider Demographics
NPI:1669347217
Name:EPHANGA, GERMAINE IMBOLO
Entity type:Individual
Prefix:
First Name:GERMAINE
Middle Name:IMBOLO
Last Name:EPHANGA
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 1:10410 KENSINGTON PKWY STE 212
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2947
Mailing Address - Country:US
Mailing Address - Phone:301-942-1401
Mailing Address - Fax:301-942-1402
Practice Address - Street 1:3005 BLADENSBURG RD NE STE 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2265
Practice Address - Country:US
Practice Address - Phone:202-635-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1054687163WC1500X
MDR232870163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health