Provider Demographics
NPI:1992255210
Name:NADIANI PONE, FNU
Entity type:Individual
Prefix:
First Name:FNU
Middle Name:
Last Name:NADIANI PONE
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 1:1515 BENNING RD NE
Mailing Address - Street 2:APT L 23
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4539
Mailing Address - Country:US
Mailing Address - Phone:202-560-1941
Mailing Address - Fax:
Practice Address - Street 1:1515 BENNING RD NE
Practice Address - Street 2:APT L 23
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4539
Practice Address - Country:US
Practice Address - Phone:202-560-1941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12460374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide