Provider Demographics
NPI:1215533831
Name:DEBREW, JANELL ERSELL
Entity Type:Individual
Prefix:MS
First Name:JANELL
Middle Name:ERSELL
Last Name:DEBREW
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 1:16303 AYRWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1536
Mailing Address - Country:US
Mailing Address - Phone:202-271-3186
Mailing Address - Fax:301-390-3529
Practice Address - Street 1:16303 AYRWOOD LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1536
Practice Address - Country:US
Practice Address - Phone:202-271-3186
Practice Address - Fax:301-390-3529
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD160368234684343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)