Healthcare Provider Details

I. General information

NPI: 1083251052
Provider Name (Legal Business Name): NAHJELA FELICIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3817 64TH AVE APT 101
HYATTSVILLE MD
20784-1857
US

IV. Provider business mailing address

3817 64TH AVE APT 101
HYATTSVILLE MD
20784-1857
US

V. Phone/Fax

Practice location:
  • Phone: 240-495-9753
  • Fax:
Mailing address:
  • Phone: 240-495-9753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: