Basic Information
| Provider Information | |||||||||
| NPI: | 1003258450 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAMA AFANWI | ||||||||
| FirstName: | NEBA | ||||||||
| MiddleName: | REGINA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3202 TOLEDO PL | ||||||||
| Address2: | APT. 101 | ||||||||
| City: | HYATTSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207824113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3013021961 | ||||||||
| FaxNumber: | 2026355780 | ||||||||
| Practice Location | |||||||||
| Address1: | 1731 BUNKER HILL RD NE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200173026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2026355756 | ||||||||
| FaxNumber: | 2026355780 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2013 | ||||||||
| LastUpdateDate: | 07/26/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | LPN1005998 | DC | Y | Agencies | Home Health |
No ID Information.