Provider Demographics
NPI:1144015652
Name:NJICHA MIRABEL, NKEMAWUNGNJIA
Entity type:Individual
Prefix:
First Name:NKEMAWUNGNJIA
Middle Name:
Last Name:NJICHA MIRABEL
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 1:9823 GOOD LUCK RD APT 10
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3363
Mailing Address - Country:US
Mailing Address - Phone:301-793-4759
Mailing Address - Fax:
Practice Address - Street 1:9823 GOOD LUCK RD APT 10
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3363
Practice Address - Country:US
Practice Address - Phone:301-793-4759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health