Provider Demographics
NPI:1083165781
Name:AZAH, ESTHER A (CNA)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:A
Last Name:AZAH
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13502 ATTLEBORO CT APT 11
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1556
Mailing Address - Country:US
Mailing Address - Phone:301-277-4337
Mailing Address - Fax:301-277-4335
Practice Address - Street 1:13502 ATTLEBORO CT APT 11
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1556
Practice Address - Country:US
Practice Address - Phone:301-277-4337
Practice Address - Fax:301-277-4335
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA001596663747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant