Provider Demographics
NPI:1346064813
Name:SHIRI, NOELLA FORBAYIEN
Entity type:Individual
Prefix:
First Name:NOELLA
Middle Name:FORBAYIEN
Last Name:SHIRI
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 1:5028 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1630
Mailing Address - Country:US
Mailing Address - Phone:602-576-2223
Mailing Address - Fax:
Practice Address - Street 1:5028 57TH AVE
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1630
Practice Address - Country:US
Practice Address - Phone:602-576-2223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide