Provider Demographics
NPI:1467032037
Name:SANDRIEN, ABANGAWOH (RN)
Entity Type:Individual
Prefix:
First Name:ABANGAWOH
Middle Name:
Last Name:SANDRIEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 GREENBELT RD APT 202
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2227
Mailing Address - Country:US
Mailing Address - Phone:240-478-4718
Mailing Address - Fax:
Practice Address - Street 1:10001 GREENBELT RD APT 202
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2227
Practice Address - Country:US
Practice Address - Phone:240-478-4718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1060079163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty