Provider Demographics
NPI:1720779168
Name:AYANOU, BLESSING VONONDE (FNP)
Entity Type:Individual
Prefix:
First Name:BLESSING
Middle Name:VONONDE
Last Name:AYANOU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17720 KING WILLIAM CT
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2307
Mailing Address - Country:US
Mailing Address - Phone:267-616-0735
Mailing Address - Fax:
Practice Address - Street 1:17720 KING WILLIAM CT
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-2307
Practice Address - Country:US
Practice Address - Phone:267-616-0735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR233492363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily