MEDICARE: NOVENA HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1558891317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVENA HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	6 PIDGEON HILL DR STE 240
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20165-6147
Country	:	US
Telephone Number	:	240-426-0447
Fax Number	:	703-421-5750

Provider Business Practice Location Address
First Line	:	6 PIDGEON HILL DR STE 240
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20165-6147
Country	:	US
Telephone Number	:	240-426-0447
Fax Number	:	703-421-5750

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	BIBIANA EZEONYIM
Credential	:	LPN
Telephone Number	:	240-426-0447

Provider Enumeration Date	:	06/14/2017
Last Update Date	:	07/21/2022

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Directions to “NOVENA HEALTHCARE LLC ” Practice Location

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