Healthcare Provider Details

I. General information

NPI: 1972324598
Provider Name (Legal Business Name): ROSINE A TIKUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13013 MARTHAS CHOICE CIR
BOWIE MD
20720-4704
US

IV. Provider business mailing address

13013 MARTHAS CHOICE CIR
BOWIE MD
20720-4704
US

V. Phone/Fax

Practice location:
  • Phone: 240-468-8198
  • Fax:
Mailing address:
  • Phone: 240-468-8198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: