Healthcare Provider Details

I. General information

NPI: 1407287246
Provider Name (Legal Business Name): EMWODSH GELAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2013
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 CRITTENDEN ST NE
WASHINGTON DC
20017-3922
US

IV. Provider business mailing address

813 CRITTENDEN ST NE
WASHINGTON DC
20017-3922
US

V. Phone/Fax

Practice location:
  • Phone: 202-460-4914
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: