Individual
SANDIE HELYETTE LONFO LONTOUO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8700 CENTRAL AVE STE 302A, HYATTSVILLE, MD 20785-4853
(301) 613-9295
Mailing address
6426 EDSALL RD APT 202, ALEXANDRIA, VA 22312-6465
(571) 232-8958
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024180027
VA
363LF0000X
Family Nurse Practitioner
Primary
AC003638
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424985200
—
MD
Enumeration date
12/28/2020
Last updated
12/05/2023
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