Healthcare Provider Details

I. General information

NPI: 1386144251
Provider Name (Legal Business Name): ANNETTE NDIFOR NCHANGNWIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2018
Last Update Date: 02/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 12TH ST SE
WASHINGTON DC
20003-3722
US

IV. Provider business mailing address

7750 FINNS LN APT B1
LANHAM MD
20706-1328
US

V. Phone/Fax

Practice location:
  • Phone: 202-544-8090
  • Fax: 202-544-8091
Mailing address:
  • Phone: 442-235-6938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA13441
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: