Kongo, Damaris W

Kongo, Damaris W is an sole proprietor health care provider with primary practice located at 39 Allison Ln , Ludlow MA 01056-9201. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Community Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Nursing Service Providers / Community Health is her primary health care specialty. Kongo, Damaris W can be contacted via phone (413) 530-7318.

Contact Information

Primary practice address
39 Allison Ln Ludlow MA 01056-9201
Phone: (413) 530-7318
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Community Health 163WC1500X RN270089 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X RN270089 Massachusetts

Profile Details

NPI number 1376114009
LBN Legal business name Kongo, Damaris W
Credentials REGISTERED NURSE
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 3rd, 2021
Last updated Jan 27th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376114009 NPPES
Massachusetts Other S31366290 DRIVERS LISENCE
Massachusetts Other 00000000000 DRIVERS LISENCE

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