Healthcare Provider Details

I. General information

NPI: 1801273974
Provider Name (Legal Business Name): LYNDA OBI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2015
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7767 RIVERDALE RD APT 103
NEW CARROLLTON MD
20784-3929
US

IV. Provider business mailing address

2811 PENNSYLVANIA AVE SE
WASHINGTON DC
20020-3865
US

V. Phone/Fax

Practice location:
  • Phone: 301-518-2183
  • Fax:
Mailing address:
  • Phone: 202-894-4811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLP54878
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLP54878
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: