Provider Demographics
NPI:1003258450
Name:SAMA AFANWI, NEBA REGINA (LPN)
Entity Type:Individual
Prefix:MS
First Name:NEBA
Middle Name:REGINA
Last Name:SAMA AFANWI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 TOLEDO PL
Mailing Address - Street 2:APT. 101
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-4113
Mailing Address - Country:US
Mailing Address - Phone:301-302-1961
Mailing Address - Fax:202-635-5780
Practice Address - Street 1:1731 BUNKER HILL RD NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-3026
Practice Address - Country:US
Practice Address - Phone:202-635-5756
Practice Address - Fax:202-635-5780
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1005998251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health