Provider Demographics
NPI:1265980924
Name:ESSINGA, MARIE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:ESSINGA
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 1:8710 BARRON ST
Mailing Address - Street 2:APT
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-7237
Mailing Address - Country:US
Mailing Address - Phone:240-606-0620
Mailing Address - Fax:
Practice Address - Street 1:8710 BARRON ST
Practice Address - Street 2:APT
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-7237
Practice Address - Country:US
Practice Address - Phone:240-606-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12378374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide