Provider Demographics
NPI:1205176724
Name:EFENURE, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:EFENURE
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 1:5016 TOWNSEND WAY
Mailing Address - Street 2:APT. C-4
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1854
Mailing Address - Country:US
Mailing Address - Phone:240-413-8245
Mailing Address - Fax:
Practice Address - Street 1:5016 TOWNSEND WAY
Practice Address - Street 2:APT. C-4
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1854
Practice Address - Country:US
Practice Address - Phone:240-413-8245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide