Healthcare Provider Details

I. General information

NPI: 1154239846
Provider Name (Legal Business Name): JEAN MARIE EFE NDENE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9587 FORT FOOTE RD
FT WASHINGTON MD
20744-5725
US

IV. Provider business mailing address

9587 FORT FOOTE RD
FT WASHINGTON MD
20744-5725
US

V. Phone/Fax

Practice location:
  • Phone: 240-428-9903
  • Fax:
Mailing address:
  • Phone: 240-428-9903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: