Nelson Fokobo Mutah

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

A00194735 Issued in MD

Practice address

1836 Metzerott Rd
Adelphi, MD 20783-3475

Phone

(929) 366-6292

NPI assigned

Jun 2, 2021

Last updated

Jun 2, 2021By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1285200089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 METZEROTT RD",
            "city": "ADELPHI",
            "state": "MD",
            "postal_code": "207833475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 METZEROTT RD",
            "city": "ADELPHI",
            "state": "MD",
            "postal_code": "207833475",
            "telephone_number": "929-366-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTAH",
        "first_name": "NELSON",
        "middle_name": "FOKOBO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MD",
            "license": "A00194735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moreen Adeka Mungore
• Prosper Munjong
• Sussan Munjong
• Benadette Nga Muta
• Constance Muta
• Donald Nyingcho Muwan
• Rachel Nakhon
• Juliet C Naldo, M.D.
• Stacey Laure Nana Njiopang
• National Health Rehabilitation LLC

• Nurse's Aide in Adelphi, MD
• Providers in Adelphi, MD by specialty
• Nurse's Aide in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.