Provider Demographics
NPI:1013494913
Name:NFORGWEI, ELIENNE BERRY
Entity Type:Individual
Prefix:MISS
First Name:ELIENNE
Middle Name:BERRY
Last Name:NFORGWEI
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 1:7910 PIEDMONT AVE
Mailing Address - Street 2:
Mailing Address - City:GLENARDEN
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1739
Mailing Address - Country:US
Mailing Address - Phone:240-615-7740
Mailing Address - Fax:
Practice Address - Street 1:7910 PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:GLENARDEN
Practice Address - State:MD
Practice Address - Zip Code:20706-1739
Practice Address - Country:US
Practice Address - Phone:240-615-7740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-24
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13877374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide