Provider Demographics
NPI:1134695943
Name:HEMMINGS, ENJAMARIE
Entity Type:Individual
Prefix:
First Name:ENJAMARIE
Middle Name:
Last Name:HEMMINGS
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 1:126 RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-1141
Mailing Address - Country:US
Mailing Address - Phone:718-469-3255
Mailing Address - Fax:
Practice Address - Street 1:126 RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-1141
Practice Address - Country:US
Practice Address - Phone:718-469-3255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331476-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse