Provider Demographics
NPI:1083368377
Name:ADJAYI, BLANCINE ADJOUAVI
Entity type:Individual
Prefix:
First Name:BLANCINE
Middle Name:ADJOUAVI
Last Name:ADJAYI
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 1:1120 N TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-5638
Mailing Address - Country:US
Mailing Address - Phone:240-367-5562
Mailing Address - Fax:
Practice Address - Street 1:8150 LAKECREST DR APT 318
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3324
Practice Address - Country:US
Practice Address - Phone:443-766-5166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD376K00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide