Healthcare Provider Details

I. General information

NPI: 1225516412
Provider Name (Legal Business Name): EVELINE YEAFUH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 OLD COLUMBIA PIKE
SILVER SPRING MD
20904-2579
US

IV. Provider business mailing address

11700 OLD COLUMBIA PIKE
SILVER SPRING MD
20904-2579
US

V. Phone/Fax

Practice location:
  • Phone: 202-568-5417
  • Fax:
Mailing address:
  • Phone: 202-568-5417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberNA0000810702
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: