Provider Demographics
NPI:1316403108
Name:MORFAW, EMMERENCIA CHOFONG (NP)
Entity Type:Individual
Prefix:MRS
First Name:EMMERENCIA
Middle Name:CHOFONG
Last Name:MORFAW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5602 LAKE SPRING CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3817
Mailing Address - Country:US
Mailing Address - Phone:240-535-7674
Mailing Address - Fax:
Practice Address - Street 1:50 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-257-8496
Practice Address - Fax:202-745-4024
Is Sole Proprietor?:No
Enumeration Date:2019-02-16
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1012436163W00000X
MDAG01190062363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM610229115770OtherMARYLAND MOTOR VEHICLE