Healthcare Provider Details

I. General information

NPI: 1558040758
Provider Name (Legal Business Name): IRETIOLUWA SAHEED CPR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5436 OLD CRAIN HWY APT 1
UPPER MARLBORO MD
20772-3071
US

IV. Provider business mailing address

5436 OLD CRAIN HWY APT 1
UPPER MARLBORO MD
20772-3071
US

V. Phone/Fax

Practice location:
  • Phone: 301-454-9363
  • Fax:
Mailing address:
  • Phone: 301-454-9363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberTME5599
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200003289
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: