MEDICARE: PRECILIA ANYI ETANG

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	374U00000X	Home Health Aide		DC

General Provider Information

NPI Number	:	1629940929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRECILIA ANYI ETANG

Provider Business Mailing Address
First Line	:	912 DELRAN PL
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-5717
Country	:	US
Telephone Number	:	240-886-4483
Fax Number	:

Provider Business Practice Location Address
First Line	:	912 DELRAN PL
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-5717
Country	:	US
Telephone Number	:	240-886-4483
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2025
Last Update Date	:	09/18/2025

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Directions to “ PRECILIA ANYI ETANG ” Practice Location

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