Provider Demographics
NPI:1669913240
Name:FON, FRI NWEI I (HHA)
Entity type:Individual
Prefix:MISS
First Name:FRI
Middle Name:NWEI
Last Name:FON
Suffix:I
Gender:F
Credentials:HHA
Other - Prefix:MISS
Other - First Name:FRI
Other - Middle Name:NWEI
Other - Last Name:FON
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:HHA
Mailing Address - Street 1:11457 CHERRY HILL RD
Mailing Address - Street 2:11457 CHERRY HILL RD
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3607
Mailing Address - Country:US
Mailing Address - Phone:404-775-0544
Mailing Address - Fax:
Practice Address - Street 1:11457 CHERRY HILL RD
Practice Address - Street 2:11457 CHERRY HILL RD
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3607
Practice Address - Country:US
Practice Address - Phone:404-775-0544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC12674374U00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide