Provider Demographics
NPI:1861753626
Name:NJETI, LOVELINE BANE
Entity type:Individual
Prefix:
First Name:LOVELINE
Middle Name:BANE
Last Name:NJETI
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 1:13906 CASTLE BLVD
Mailing Address - Street 2:#T1
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4943
Mailing Address - Country:US
Mailing Address - Phone:301-256-5564
Mailing Address - Fax:
Practice Address - Street 1:13906 CASTLE BLVD
Practice Address - Street 2:#T1
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4943
Practice Address - Country:US
Practice Address - Phone:301-256-5564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDN230550081229374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide