Provider Demographics
NPI:1780018051
Name:JENETE, ANGUM BURO
Entity Type:Individual
Prefix:
First Name:ANGUM
Middle Name:BURO
Last Name:JENETE
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 1:9505 WELLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3645
Mailing Address - Country:US
Mailing Address - Phone:301-455-7539
Mailing Address - Fax:
Practice Address - Street 1:9505 WELLINGTON ST
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3645
Practice Address - Country:US
Practice Address - Phone:301-455-7539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide