Healthcare Provider Details

I. General information

NPI: 1104459007
Provider Name (Legal Business Name): EVELINE NEWAH ANNO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7826 EASTERN AVE NW STE 400
WASHINGTON DC
20012-1316
US

IV. Provider business mailing address

6823A RIVERDALE RD APT A2
RIVERDALE MD
20737-1838
US

V. Phone/Fax

Practice location:
  • Phone: 202-723-1100
  • Fax:
Mailing address:
  • Phone: 240-615-7450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA14991
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: