Healthcare Provider Details

I. General information

NPI: 1053283390
Provider Name (Legal Business Name): DDB SUPPORT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 SHININGFIELD CT
MIDDLE RIVER MD
21220-1771
US

IV. Provider business mailing address

115 SHININGFIELD CT
MIDDLE RIVER MD
21220-1771
US

V. Phone/Fax

Practice location:
  • Phone: 717-887-8692
  • Fax:
Mailing address:
  • Phone: 717-887-8692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: HELEN ESOHE ONYEULO
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 717-887-8692