Provider Demographics
NPI:1932926938
Name:NGEBI, MODESTA
Entity type:Individual
Prefix:
First Name:MODESTA
Middle Name:
Last Name:NGEBI
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 1:3318 DODGE PARK RD APT 201
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2114
Mailing Address - Country:US
Mailing Address - Phone:240-564-7386
Mailing Address - Fax:
Practice Address - Street 1:3318 DODGE PARK RD APT 201
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-2114
Practice Address - Country:US
Practice Address - Phone:240-564-7386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide