Healthcare Provider Details

I. General information

NPI: 1093200321
Provider Name (Legal Business Name): ODETTE NIANH SHEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1836 METZEROTT RD APT 1103
ADELPHI MD
20783-3448
US

IV. Provider business mailing address

2400 QUEENS CHAPEL RD APT 320
HYATTSVILLE MD
20782-3637
US

V. Phone/Fax

Practice location:
  • Phone: 240-423-7281
  • Fax:
Mailing address:
  • Phone: 240-423-7281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA13718
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: