Healthcare Provider Details

I. General information

NPI: 1013437409
Provider Name (Legal Business Name): DOROTHEE DJEUMEN NZOUAFET
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 06/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2709 NICHOLSON ST APT 303
HYATTSVILLE MD
20782-2826
US

IV. Provider business mailing address

2709 NICHOLSON ST APT 303
HYATTSVILLE MD
20782-2826
US

V. Phone/Fax

Practice location:
  • Phone: 301-793-3568
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA12851
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: