Healthcare Provider Details

I. General information

NPI: 1588290076
Provider Name (Legal Business Name): PAULA UWAHEMU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5513 ILLINOIS AVE NW
WASHINGTON DC
20011-2937
US

IV. Provider business mailing address

9727 MOUNT PISGAH RD APT T1
SILVER SPRING MD
20903-2000
US

V. Phone/Fax

Practice location:
  • Phone: 202-882-9310
  • Fax:
Mailing address:
  • Phone: 301-844-1318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA15054
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: