Gloria Adewunmi Eddo

Individual provider Active NPI Home Health Aide · Manassas Park, VA

NPI 1285900936 · NPPES record last updated Mar 27, 2012

Key facts

NPI
1285900936
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Aide 374U00000X
Practice address
8641 Sumter CT
Manassas Park, VA 20111-2365
Phone
(571) 267-9166
NPI assigned
Mar 27, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Yes

Addresses

Primary practice location

8641 Sumter CT
Manassas Park, VA 20111-2365

Mailing address

8641 Sumter CT
Manassas Park, VA 20111-2365
Phone (571) 267-9166

Other providers in Manassas Park, VA

All providers in Manassas Park, VA · Home Health Aide in Virginia

Sources for this page

Verify at the official NPI Registry.