Provider Demographics
NPI:1174957021
Name:ANU, EZINNE
Entity type:Individual
Prefix:
First Name:EZINNE
Middle Name:
Last Name:ANU
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 1:7001 GOOD LUCK RD
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3621
Mailing Address - Country:US
Mailing Address - Phone:240-696-9431
Mailing Address - Fax:
Practice Address - Street 1:1220 12TH ST SE STE 350
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3727
Practice Address - Country:US
Practice Address - Phone:202-846-6830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1058770163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse