MEDICARE: ROSEMARIE MARIATU KPAKA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide	HHA12506	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225571979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARIE MARIATU KPAKA

Provider Business Mailing Address
First Line	:	7203 ADELPHI RD
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20782-1004
Country	:	US
Telephone Number	:	240-495-4981
Fax Number	:

Provider Business Practice Location Address
First Line	:	7203 ADELPHI RD
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20782-1004
Country	:	US
Telephone Number	:	240-495-4981
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2016
Last Update Date	:	11/29/2016

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