Provider Demographics
NPI:1518212497
Name:VARNER, EBONI
Entity Type:Individual
Prefix:
First Name:EBONI
Middle Name:
Last Name:VARNER
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 1:2401 DAREL DR APT 201
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4818
Mailing Address - Country:US
Mailing Address - Phone:202-492-8653
Mailing Address - Fax:
Practice Address - Street 1:2401 DAREL DR APT 201
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-4818
Practice Address - Country:US
Practice Address - Phone:202-492-8653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide