Healthcare Provider Details

I. General information

NPI: 1487441135
Provider Name (Legal Business Name): MEYEVI AFANYIAKOSSOU-GBAGBA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2025
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 K ST NE # DC
WASHINGTON DC
20002-4216
US

IV. Provider business mailing address

35 K ST NE
WASHINGTON DC
20002-4216
US

V. Phone/Fax

Practice location:
  • Phone: 202-839-3500
  • Fax: 202-559-3949
Mailing address:
  • Phone: 202-442-4202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN500011482
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: