Provider Demographics
NPI:1609676147
Name:MARFO, NICOLE TWENEBOA
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:TWENEBOA
Last Name:MARFO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 BELAIR GATE LN
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1944
Mailing Address - Country:US
Mailing Address - Phone:443-403-9901
Mailing Address - Fax:
Practice Address - Street 1:3111 BELAIR GATE LN
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-1944
Practice Address - Country:US
Practice Address - Phone:443-403-9901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR245645163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse