Provider Demographics
NPI:1528327434
Name:NKOYOK, JOB EDOUARD
Entity type:Individual
Prefix:MR
First Name:JOB
Middle Name:EDOUARD
Last Name:NKOYOK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5445 16TH AVE
Mailing Address - Street 2:APT T3
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3423
Mailing Address - Country:US
Mailing Address - Phone:240-271-3827
Mailing Address - Fax:
Practice Address - Street 1:5445 16TH AVE
Practice Address - Street 2:APT T3
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3423
Practice Address - Country:US
Practice Address - Phone:240-271-3827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
MD374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide