Provider Demographics
NPI:1851180038
Name:NKWA STEPHEN, NFORNJOCK
Entity type:Individual
Prefix:
First Name:NFORNJOCK
Middle Name:
Last Name:NKWA STEPHEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 WESTCHESTER PARK DR APT 1514
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2842
Mailing Address - Country:US
Mailing Address - Phone:240-445-1123
Mailing Address - Fax:
Practice Address - Street 1:1818 NEW YORK AVE NE STE 203
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1849
Practice Address - Country:US
Practice Address - Phone:800-507-5550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator