Healthcare Provider Details

I. General information

NPI: 1063027027
Provider Name (Legal Business Name): ADESUWA EJEHI ABULU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 S ST SE
WASHINGTON DC
20020-6925
US

IV. Provider business mailing address

3310 PARKFORD MANOR TER APT L
SILVER SPRING MD
20904-6146
US

V. Phone/Fax

Practice location:
  • Phone: 202-538-1910
  • Fax:
Mailing address:
  • Phone: 404-477-8534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberHHA200002596
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA00177833
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200002596
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: