Provider Demographics
NPI:1093140865
Name:NDE, FNU EDITH ANWI
Entity Type:Individual
Prefix:MISS
First Name:FNU EDITH
Middle Name:ANWI
Last Name:NDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4203 OGLETHORPE ST
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-1533
Mailing Address - Country:US
Mailing Address - Phone:301-640-9480
Mailing Address - Fax:
Practice Address - Street 1:4203 OGLETHORPE ST
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781-1533
Practice Address - Country:US
Practice Address - Phone:301-640-9480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA7357374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide