Provider Demographics
NPI:1144067489
Name:MBOLLE, SYLVIE GLORIA (CNA)
Entity type:Individual
Prefix:MS
First Name:SYLVIE
Middle Name:GLORIA
Last Name:MBOLLE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 HAMPSHIRE WEST CT APT 12
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2529
Mailing Address - Country:US
Mailing Address - Phone:725-252-8387
Mailing Address - Fax:
Practice Address - Street 1:3304 18TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2720
Practice Address - Country:US
Practice Address - Phone:202-830-5948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant