Provider Demographics
NPI:1578302832
Name:DWEH, FORSTILIAL ABBAH
Entity type:Individual
Prefix:
First Name:FORSTILIAL
Middle Name:ABBAH
Last Name:DWEH
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 1:3009 31ST AVE W APT 317A
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-6964
Mailing Address - Country:US
Mailing Address - Phone:314-249-2007
Mailing Address - Fax:
Practice Address - Street 1:3009 31ST AVE W APT 317A
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-6964
Practice Address - Country:US
Practice Address - Phone:314-249-2007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion