Provider Demographics
NPI:1881208486
Name:NONO, ALVINE C
Entity Type:Individual
Prefix:
First Name:ALVINE
Middle Name:C
Last Name:NONO
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 1:1500 SOUTHERN SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-6088
Mailing Address - Country:US
Mailing Address - Phone:240-917-0267
Mailing Address - Fax:
Practice Address - Street 1:1500 SOUTHERN SPRINGS LN
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-6088
Practice Address - Country:US
Practice Address - Phone:240-917-0267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA00176233Medicaid