Healthcare Provider Details

I. General information

NPI: 1982375994
Provider Name (Legal Business Name): ELIZABETH A BECHEM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 FALCON DR
UPPER MARLBORO MD
20774-5738
US

IV. Provider business mailing address

2512 24TH ST NE
WASHINGTON DC
20018-2126
US

V. Phone/Fax

Practice location:
  • Phone: 240-691-7715
  • Fax:
Mailing address:
  • Phone: 202-832-8340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200001941
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA00181483
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: