Provider Demographics
NPI:1124838990
Name:ANUATEZI, SANDRA NGIFOR
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:NGIFOR
Last Name:ANUATEZI
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 1:5312 85TH AVE APT D8
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3245
Mailing Address - Country:US
Mailing Address - Phone:240-437-8404
Mailing Address - Fax:
Practice Address - Street 1:5312 85TH AVE APT D8
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3245
Practice Address - Country:US
Practice Address - Phone:240-437-8404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide