Provider Demographics
NPI:1861890279
Name:NYIAWUNG, VERA ALEMFUA
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:ALEMFUA
Last Name:NYIAWUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VERA
Other - Middle Name:
Other - Last Name:AWUNGANYI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8501 SHELLEY CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4472
Mailing Address - Country:US
Mailing Address - Phone:240-755-3265
Mailing Address - Fax:
Practice Address - Street 1:1418 GOOD HOPE RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5615
Practice Address - Country:US
Practice Address - Phone:202-558-2448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC11017374U00000X
DCRN200006617163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No374U00000XNursing Service Related ProvidersHome Health Aide