Provider Demographics
NPI:1992535041
Name:TCHINDA, CHRISTELLE
Entity type:Individual
Prefix:
First Name:CHRISTELLE
Middle Name:
Last Name:TCHINDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TCHINDA
Other - Middle Name:CHRISTELLE
Other - Last Name:TCHAMOLOGNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5426 DARLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-4132
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 BILLINGSLEY RD
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3400
Practice Address - Country:US
Practice Address - Phone:202-849-5619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR230498163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse