Provider Demographics
NPI:1730590092
Name:NGERE, EVEREST
Entity type:Individual
Prefix:
First Name:EVEREST
Middle Name:
Last Name:NGERE
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 1:9871 GOOD LUCK RD APT T1
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3206
Mailing Address - Country:US
Mailing Address - Phone:301-536-6821
Mailing Address - Fax:
Practice Address - Street 1:9871 GOOD LUCK RD APT T1
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3206
Practice Address - Country:US
Practice Address - Phone:301-536-6821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA5372374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide