Healthcare Provider Details

I. General information

NPI: 1225398449
Provider Name (Legal Business Name): LORRAINE ODAY SEWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9504 STONEY RIDGE RD
SPRINGDALE MD
20774-5442
US

IV. Provider business mailing address

1105 NALLEY RD APT 841
LANDOVER MD
20785-4425
US

V. Phone/Fax

Practice location:
  • Phone: 240-643-1391
  • Fax:
Mailing address:
  • Phone: 301-772-4042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA2451
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: