Individual
TSUEPOUPNO OFON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 DODGE PARK RD, # 201, HYATTSVILLE, MD 20785-2001
(240) 413-1123
Mailing address
3400 DODGE PARK RD, # 201, HYATTSVILLE, MD 20785-2001
(240) 413-1123
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN500019912
DC
374U00000X
Home Health Aide
—
—
Other
Enumeration date
04/22/2015
Last updated
07/25/2024
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