Provider Demographics
NPI:1851683304
Name:KANJANDA, THANDIWE EVELYNE (LPN)
Entity Type:Individual
Prefix:MS
First Name:THANDIWE
Middle Name:EVELYNE
Last Name:KANJANDA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE 74TH ST
Mailing Address - Street 2:APT # 6B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209
Mailing Address - Country:US
Mailing Address - Phone:317-850-1393
Mailing Address - Fax:
Practice Address - Street 1:ONE 74TH ST
Practice Address - Street 2:APT # 6B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:317-850-1393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305229164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse