Provider Demographics
NPI:1972327229
Name:KENGNE MASSOH EPSE NA, VINETTE
Entity type:Individual
Prefix:
First Name:VINETTE
Middle Name:
Last Name:KENGNE MASSOH EPSE NA
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 1:7841 RIVERDALE RD APT 102
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-4023
Mailing Address - Country:US
Mailing Address - Phone:240-413-2237
Mailing Address - Fax:
Practice Address - Street 1:7841 RIVERDALE RD APT 102
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-4023
Practice Address - Country:US
Practice Address - Phone:240-413-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide