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General NPI Number Information
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NPI Number | 1033478029
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Entity Type | Individual
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Provider Name | ROSELYN NDIDIAMAKA UKAOBASI X
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Gender | Female
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 03/01/2018
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Provider Practice Location Address
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Address Line | 6319 LANDOVER RD
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City | CHEVERLY
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State | MD
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Zip | 20785-1320
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Country | US
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Telephone | 202-550-7742
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Fax |
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Provider Business Mailing Address
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Address Line | 6023 SPRINGHILL DR APT 304
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City | GREENBELT
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State | MD
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Zip | 20770-6117
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Country | US
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Telephone | 301-232-6528
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | U212744612636
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | HHA3590
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License Number State | DC
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