Provider Demographics
NPI:1194346239
Name:FORLU, MERCY
Entity type:Individual
Prefix:
First Name:MERCY
Middle Name:
Last Name:FORLU
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 1:4601 PRESIDENTS DR STE 232
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4870
Mailing Address - Country:US
Mailing Address - Phone:202-359-9725
Mailing Address - Fax:301-441-2360
Practice Address - Street 1:4601 PRESIDENTS DR STE 232
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4870
Practice Address - Country:US
Practice Address - Phone:202-359-9725
Practice Address - Fax:301-441-2360
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN967341163W00000X
MDR156069163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF-640-599-631-567OtherDRIVER'S LICENSE