Healthcare Provider Details

I. General information

NPI: 1710743745
Provider Name (Legal Business Name): EBANE ETAPE FLORENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2024
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9219 MORLEY RD
LANHAM MD
20706-4142
US

IV. Provider business mailing address

9219 MORLEY RD
LANHAM MD
20706-4142
US

V. Phone/Fax

Practice location:
  • Phone: 240-696-9968
  • Fax:
Mailing address:
  • Phone: 240-696-9968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberHHA200003476
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200003476
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: