Provider Demographics
NPI:1417693144
Name:GUEFAH, RENINE MIAFO
Entity Type:Individual
Prefix:
First Name:RENINE
Middle Name:MIAFO
Last Name:GUEFAH
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 1:7867 AMERICANA CIR APT 103
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-7860
Mailing Address - Country:US
Mailing Address - Phone:240-425-3372
Mailing Address - Fax:
Practice Address - Street 1:7867 AMERICANA CIR APT 103
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-7860
Practice Address - Country:US
Practice Address - Phone:240-425-3372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR246561163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse