Provider Demographics
NPI:1285004309
Name:AMOAFO, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:AMOAFO
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 1:2916 FURMAN LN APT T1
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-1010
Mailing Address - Country:US
Mailing Address - Phone:703-768-5694
Mailing Address - Fax:
Practice Address - Street 1:2916 FURMAN LN APT T1
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-1010
Practice Address - Country:US
Practice Address - Phone:703-768-5694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401107877376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide