Healthcare Provider Details

I. General information

NPI: 1730037672
Provider Name (Legal Business Name): FATI NACOULMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 SOUTHAMPTON DR
SILVER SPRING MD
20903-2622
US

IV. Provider business mailing address

211 SOUTHAMPTON DR
SILVER SPRING MD
20903-2622
US

V. Phone/Fax

Practice location:
  • Phone: 240-355-4804
  • Fax:
Mailing address:
  • Phone: 240-355-4804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: