Healthcare Provider Details

I. General information

NPI: 1346753100
Provider Name (Legal Business Name): JOSEPHINE LEKEAKA NKEFUA EPSE N
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 11/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14805 ASHFORD PL
LAUREL MD
20707-3771
US

IV. Provider business mailing address

14805 ASHFORD PL
LAUREL MD
20707-3771
US

V. Phone/Fax

Practice location:
  • Phone: 240-413-7229
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNA0000811080
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA13272
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: