Provider Demographics
NPI:1336611243
Name:EPANLO EPANDA, FRANK
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:EPANLO EPANDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 QUARLES ST NE APT 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-8153
Mailing Address - Country:US
Mailing Address - Phone:202-826-0545
Mailing Address - Fax:
Practice Address - Street 1:4925 QUARLES ST NE APT 101
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-8153
Practice Address - Country:US
Practice Address - Phone:202-826-0545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14169374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide