Provider Demographics
NPI:1225392129
Name:NDUKUBA, CHARECE (HHA)
Entity type:Individual
Prefix:
First Name:CHARECE
Middle Name:
Last Name:NDUKUBA
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9318 GEATON PARK PL
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2682
Mailing Address - Country:US
Mailing Address - Phone:240-604-2502
Mailing Address - Fax:202-545-0934
Practice Address - Street 1:9318 GEATON PARK PL
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2682
Practice Address - Country:US
Practice Address - Phone:260-604-2602
Practice Address - Fax:202-545-0934
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No374U00000XNursing Service Related ProvidersHome Health Aide