Provider Demographics
NPI:1457711616
Name:HONFO, ELOGNISSE C
Entity type:Individual
Prefix:
First Name:ELOGNISSE
Middle Name:C
Last Name:HONFO
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 1:2013 TREETOP LN
Mailing Address - Street 2:APT 21
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7689
Mailing Address - Country:US
Mailing Address - Phone:240-505-4114
Mailing Address - Fax:
Practice Address - Street 1:2013 TREETOP LN
Practice Address - Street 2:APT 21
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7689
Practice Address - Country:US
Practice Address - Phone:240-505-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHHA11840374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide