Healthcare Provider Details

I. General information

NPI: 1871425637
Provider Name (Legal Business Name): GILLIAN KULEMIA MBELIKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6202 SURREY SQUARE LN APT T2
DISTRICT HEIGHTS MD
20747-2945
US

IV. Provider business mailing address

6202 SURREY SQUARE LN APT T2
DISTRICT HEIGHTS MD
20747-2945
US

V. Phone/Fax

Practice location:
  • Phone: 202-839-1421
  • Fax:
Mailing address:
  • Phone: 202-839-1421
  • 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: