Provider Demographics
NPI:1194577114
Name:NYENDIA, FADRISE ALEM
Entity type:Individual
Prefix:
First Name:FADRISE
Middle Name:ALEM
Last Name:NYENDIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6670 GEORGIA AVE NW APT 203
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2550
Mailing Address - Country:US
Mailing Address - Phone:202-500-6205
Mailing Address - Fax:
Practice Address - Street 1:6670 GEORGIA AVE NW APT 203
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2550
Practice Address - Country:US
Practice Address - Phone:202-500-6205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide