Provider Demographics
NPI:1750051801
Name:DJOMENI EKE, ELODIE CARINE
Entity Type:Individual
Prefix:
First Name:ELODIE
Middle Name:CARINE
Last Name:DJOMENI EKE
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 1:6700 BELCREST RD APT 623
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-1348
Mailing Address - Country:US
Mailing Address - Phone:202-790-7294
Mailing Address - Fax:
Practice Address - Street 1:6700 BELCREST RD APT 623
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-1348
Practice Address - Country:US
Practice Address - Phone:202-790-7294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-19
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A00195096376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide