Provider Demographics
NPI:1548622939
Name:MENTONGA, LOVELINE NJUKANG (RN)
Entity type:Individual
Prefix:
First Name:LOVELINE
Middle Name:NJUKANG
Last Name:MENTONGA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:LOVELINE
Other - Middle Name:NJUKANG
Other - Last Name:MENTONGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:11102 OLD YORK RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2228
Mailing Address - Country:US
Mailing Address - Phone:240-696-9066
Mailing Address - Fax:
Practice Address - Street 1:3300 PENNSYLVANIA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2408
Practice Address - Country:US
Practice Address - Phone:202-878-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1040182163W00000X
DCNP1040182363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse