Provider Demographics
NPI:1376216473
Name:NWANNA, VALENTINE
Entity Type:Individual
Prefix:
First Name:VALENTINE
Middle Name:
Last Name:NWANNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8031 IANS ALY
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-6134
Mailing Address - Country:US
Mailing Address - Phone:240-714-1626
Mailing Address - Fax:
Practice Address - Street 1:1323 28TH ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3602
Practice Address - Country:US
Practice Address - Phone:240-716-1626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide