Provider Demographics
NPI:1174048714
Name:AKENJI, AWOH B
Entity type:Individual
Prefix:
First Name:AWOH
Middle Name:B
Last Name:AKENJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 TOLEDO PL APT 102
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-8142
Mailing Address - Country:US
Mailing Address - Phone:240-505-2462
Mailing Address - Fax:
Practice Address - Street 1:3200 TOLEDO PL APT 102
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-8142
Practice Address - Country:US
Practice Address - Phone:240-505-2462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN1005901164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty