Provider Demographics
NPI:1417214040
Name:EFUETNKENG, PATIENCE A
Entity Type:Individual
Prefix:
First Name:PATIENCE
Middle Name:A
Last Name:EFUETNKENG
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 1:3623 JEFF RD
Mailing Address - Street 2:
Mailing Address - City:GLENARDEN
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2612
Mailing Address - Country:US
Mailing Address - Phone:240-704-0853
Mailing Address - Fax:
Practice Address - Street 1:7729 RIVERDALE RD
Practice Address - Street 2:APT# 302
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3951
Practice Address - Country:US
Practice Address - Phone:202-722-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide