Healthcare Provider Details

I. General information

NPI: 1669731287
Provider Name (Legal Business Name): LOVELINE LENYOAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 12/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 GEORGIA AVE NW SUIT 323
WASHINGTON DC
20012-1616
US

IV. Provider business mailing address

7600 GEORGIA AVENUE SUIT 323
WASHINGTON DC
20012
US

V. Phone/Fax

Practice location:
  • Phone: 202-723-3060
  • Fax: 202-723-3065
Mailing address:
  • Phone: 202-723-3060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberL-145-506-025-364
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN1006577
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: