Provider Demographics
NPI:1790667723
Name:ABUNGWI AKWANGA, AGNES NENGI (LPN)
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:NENGI
Last Name:ABUNGWI AKWANGA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 CRAIN HWY STE 202
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3190
Mailing Address - Country:US
Mailing Address - Phone:786-788-5080
Mailing Address - Fax:786-788-5084
Practice Address - Street 1:2255 CRAIN HWY STE 202
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-3190
Practice Address - Country:US
Practice Address - Phone:786-788-5080
Practice Address - Fax:786-788-5084
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP48427164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse