MEDICARE: VANESSA NTANI NSODUFE

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	HHA12834	DC

General Provider Information

NPI Number	:	1689196909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA NTANI NSODUFE

Provider Business Mailing Address
First Line	:	6707 W FOREST RD
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-3315
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6323 GEORGIA AVE NW STE 105
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-1137
Country	:	US
Telephone Number	:	240-593-4750
Fax Number	:	240-593-4750

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

Provider Enumeration Date	:	07/07/2017
Last Update Date	:	07/07/2017

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Directions to “ VANESSA NTANI NSODUFE ” Practice Location

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