Provider Demographics
NPI:1598513152
Name:ENEKE, AGNES EBAGGE (HHA)
Entity type:Individual
Prefix:MISS
First Name:AGNES EBAGGE
Middle Name:
Last Name:ENEKE
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:MISS
Other - First Name:AGNES EBAGGE
Other - Middle Name:
Other - Last Name:ENEKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2736 ZEEK LN
Mailing Address - Street 2:
Mailing Address - City:GLENARDEN
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1405
Mailing Address - Country:US
Mailing Address - Phone:240-960-8565
Mailing Address - Fax:
Practice Address - Street 1:2736 ZEEK LN
Practice Address - Street 2:
Practice Address - City:GLENARDEN
Practice Address - State:MD
Practice Address - Zip Code:20706-1405
Practice Address - Country:US
Practice Address - Phone:240-960-8565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200003621374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide