Healthcare Provider Details

I. General information

NPI: 1144953829
Provider Name (Legal Business Name): NKIRUKA EUCHARIA UKAOBASI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4837 3RD ST NW
WASHINGTON DC
20011-4783
US

IV. Provider business mailing address

4837 3RD ST NW
WASHINGTON DC
20011-4783
US

V. Phone/Fax

Practice location:
  • Phone: 202-378-4913
  • Fax:
Mailing address:
  • Phone: 202-378-4913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA00200951
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: