Healthcare Provider Details

I. General information

NPI: 1487164489
Provider Name (Legal Business Name): AURELIE HUGUETTE TIOKENG TAKUETE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2017
Last Update Date: 03/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1822 JEFFERSON PL NW
WASHINGTON DC
20036-2505
US

IV. Provider business mailing address

6733 NEW HAMPSHIRE AVE APT 603
TAKOMA PARK MD
20912-2849
US

V. Phone/Fax

Practice location:
  • Phone: 202-293-2931
  • Fax:
Mailing address:
  • Phone: 301-273-8765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberHHA13113
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: