Healthcare Provider Details

I. General information

NPI: 1760737704
Provider Name (Legal Business Name): STELLA ABANE ENANG HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2012
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1656 UNIVERSITY BLVD W
SILVER SPRING MD
20902-3649
US

IV. Provider business mailing address

21 FEATHERWOOD CT APT 43
SILVER SPRING MD
20904-7621
US

V. Phone/Fax

Practice location:
  • Phone: 202-520-3689
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR229056
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: