Basic Information
| Provider Information | |||||||||
| NPI: | 1578036844 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SONGOWA | ||||||||
| FirstName: | WULLAIMATU | ||||||||
| MiddleName: | HANNA BUNDU | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7937 JOHNSON AVE APT 1322 | ||||||||
| Address2: | |||||||||
| City: | GLENARDEN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207061749 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1100 NEW JERSEY AVE SE STE 845 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200033338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2025456980 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2019 | ||||||||
| LastUpdateDate: | 01/09/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WH0200X | RN1007859 | DC | Y | Nursing Service Providers | Registered Nurse | Home Health |
No ID Information.