Provider Demographics
NPI:1114496668
Name:GERMAINE, ACHIANGAH
Entity Type:Individual
Prefix:
First Name:ACHIANGAH
Middle Name:
Last Name:GERMAINE
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 1:7600 FONTAINEBLEAU DR APT 712
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3840
Mailing Address - Country:US
Mailing Address - Phone:301-755-3310
Mailing Address - Fax:
Practice Address - Street 1:7600 FONTAINEBLEAU DR APT 712
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3840
Practice Address - Country:US
Practice Address - Phone:301-755-3310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2024-02-13
Deactivation Date:2022-12-16
Deactivation Code:
Reactivation Date:2024-02-13
Provider Licenses
StateLicense IDTaxonomies
DCHHA14090374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide