Healthcare Provider Details

I. General information

NPI: 1669742854
Provider Name (Legal Business Name): EVELYNE K. MANTAB-AKEM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2012
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2023017717
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: