Provider Demographics
NPI:1952799223
Name:EUPHRASIA, ENANGA
Entity Type:Individual
Prefix:
First Name:ENANGA
Middle Name:
Last Name:EUPHRASIA
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 1:8106 MANDAN TER
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2638
Mailing Address - Country:US
Mailing Address - Phone:240-898-8769
Mailing Address - Fax:
Practice Address - Street 1:8106 MANDAN TER
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2638
Practice Address - Country:US
Practice Address - Phone:240-898-8769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide