Provider Demographics
NPI:1184072928
Name:ONANA EPSE ONANA, EDWIGE SANDRINE
Entity type:Individual
Prefix:
First Name:EDWIGE SANDRINE
Middle Name:
Last Name:ONANA EPSE ONANA
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 1:2012 DREXEL ST APT 202
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-4103
Mailing Address - Country:US
Mailing Address - Phone:240-467-6694
Mailing Address - Fax:
Practice Address - Street 1:2012 DREXEL ST APT 202
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-4103
Practice Address - Country:US
Practice Address - Phone:240-467-6694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-02
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12088251E00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No251E00000XAgenciesHome Health