Healthcare Provider Details

I. General information

NPI: 1891614202
Provider Name (Legal Business Name): MAURINE MANGI NFORBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9514 MUIRKIRK RD APT 1
LAUREL MD
20708-3080
US

IV. Provider business mailing address

9514 MUIRKIRK RD APT 1
LAUREL MD
20708-3080
US

V. Phone/Fax

Practice location:
  • Phone: 240-991-8228
  • Fax:
Mailing address:
  • Phone: 240-991-8228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200006496
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: