Provider Demographics
NPI:1699588012
Name:BEMPONG, JANE
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:BEMPONG
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 1:11140 ROCKVILLE PIKE STE 100-738
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3106
Mailing Address - Country:US
Mailing Address - Phone:240-575-2203
Mailing Address - Fax:
Practice Address - Street 1:11140 ROCKVILLE PIKE STE 100-738
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3106
Practice Address - Country:US
Practice Address - Phone:240-575-2203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program