Healthcare Provider Details

I. General information

NPI: 1114895257
Provider Name (Legal Business Name): VERA TEBID ETIH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 EWELL LN
LANDOVER MD
20785-1961
US

IV. Provider business mailing address

3004 EWELL LN
LANDOVER MD
20785-1961
US

V. Phone/Fax

Practice location:
  • Phone: 227-256-9689
  • Fax:
Mailing address:
  • Phone: 227-256-9689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberHHA200005919
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200005919
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: