Provider Demographics
NPI:1629337233
Name:AKINWANDE, ELIZABETH A
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:AKINWANDE
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 1:5178 EASTERN AVE NE
Mailing Address - Street 2:APT 202
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-2769
Mailing Address - Country:US
Mailing Address - Phone:202-340-8135
Mailing Address - Fax:
Practice Address - Street 1:5178 EASTERN AVE NE
Practice Address - Street 2:APT 202
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-2769
Practice Address - Country:US
Practice Address - Phone:202-340-8135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2691479374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide