Healthcare Provider Details

I. General information

NPI: 1881297810
Provider Name (Legal Business Name): MERLINE FLORE DJEUMENI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2020
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7826 EASTERN AVE NW
WASHINGTON DC
20012-1324
US

IV. Provider business mailing address

4501 CLERMONT DR NE APT 104
WASHINGTON DC
20011-4948
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA15145
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: