Agnes M Mpanja, CWON

Primary specialty

Ostomy Care Registered NurseTaxonomy code 163WX1500X

License

R182828 Issued in MD

Practice address

6664 Ballenger Run Blvd
Frederick, MD 21703-7918

Phone

(240) 305-7922

NPI assigned

Jun 15, 2024

Last updated

Jun 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reliable Wound Ostomy Consultant LLC

  • Home Health Agency
  • Frederick, MD
  • NPI 1710776778
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1255174470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6664 BALLENGER RUN BLVD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037918",
            "telephone_number": "240-305-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6664 BALLENGER RUN BLVD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037918",
            "telephone_number": "240-305-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MPANJA",
        "first_name": "AGNES",
        "middle_name": "M",
        "credential": "CWON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-15",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ostomy Care",
            "state": "MD",
            "license": "R182828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moving Forward Inc
• Andrew D. Mowery, DO
• Leah Moxley
• Mikayla Moxley
• Andrea Isabelle Moya Munoz, PLC
• Ms-HC, LLC (Frederick-MED LLC)
• MSC Ambulatory Surgical Center LLC
• Linda Crum Muehl, CRNP
• Nyasha Hazel Mufuka, MD
• Kabuiya R Mugera, M.D.

• Registered Nurse in Frederick, MD
• Providers in Frederick, MD by specialty
• Registered Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.