Provider Demographics
NPI:1427508274
Name:EKPE, COMFORT ISONG (CIE)
Entity type:Individual
Prefix:
First Name:COMFORT
Middle Name:ISONG
Last Name:EKPE
Suffix:
Gender:F
Credentials:CIE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13807 CASTLE BLVD APT 23
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7318
Mailing Address - Country:US
Mailing Address - Phone:443-741-0182
Mailing Address - Fax:
Practice Address - Street 1:13807 CASTLE BLVD APT 23
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7318
Practice Address - Country:US
Practice Address - Phone:443-741-0182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12452374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide