Healthcare Provider Details

I. General information

NPI: 1124780135
Provider Name (Legal Business Name): GILBERT KWEYILA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 K ST NW STE 700
WASHINGTON DC
20005-2516
US

IV. Provider business mailing address

1420 K ST NW STE 700
WASHINGTON DC
20005-2516
US

V. Phone/Fax

Practice location:
  • Phone: 202-293-2931
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberHHA200001408
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberHHA200001408
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: