Healthcare Provider Details

I. General information

NPI: 1578491411
Provider Name (Legal Business Name): ELIZABETH MENSAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9706 DUBARRY ST
GLENN DALE MD
20769-9285
US

IV. Provider business mailing address

9706 DUBARRY ST
GLENN DALE MD
20769-9285
US

V. Phone/Fax

Practice location:
  • Phone: 240-729-2071
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA00132905
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: