Kenneth Vondell Mallory
Registered Nurse in Washington, DC. Individual provider (NPI-1).
NPI number1982251187
StatusActive
Last updated in NPPESAug 22, 2019
Details
- NPI
- 1982251187
- Entity type
- Individual (NPI-1)
- Name
- Kenneth Vondell Mallory
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 22, 2019
- Last updated
- Aug 22, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | RN58728 | DC | Yes |
Practice location
501 School St Sw Ste 200Washington, DC 20024-2774
Phone 703-752-8700
Mailing address
7402 Fawley AveFort Washington, MD 20744-2124
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