Provider Demographics
NPI:1063116408
Name:ANDINWO, PEARL
Entity type:Individual
Prefix:
First Name:PEARL
Middle Name:
Last Name:ANDINWO
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 1:9112 91ST PL
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1918
Mailing Address - Country:US
Mailing Address - Phone:240-726-8249
Mailing Address - Fax:
Practice Address - Street 1:9112 91ST PL
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1918
Practice Address - Country:US
Practice Address - Phone:240-726-8249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide