Individual
ANASTASIE MBONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 W WASHINGTON ST, CHARLES TOWN, WV 25414-1531
(304) 724-2135
(304) 724-2137
Mailing address
658 CHAPELGATE DR, ODENTON, MD 21113-2140
(301) 806-2953
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MD
251E00000X
Home Health Agency
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP298832
NURSING LICENSE
MD
Enumeration date
04/29/2021
Last updated
04/29/2021
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