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General NPI Number Information
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NPI Number | 1063027027
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Entity Type | Individual
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Provider Name | ADESUWA EJEHI ABULU
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Gender | Female
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 09/15/2020
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Provider Practice Location Address
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Address Line | 1315 S ST SE
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City | WASHINGTON
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State | DC
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Zip | 20020-6925
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Country | US
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Telephone | 202-538-1910
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Fax |
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Provider Business Mailing Address
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Address Line | 3310 PARKFORD MANOR TER APT L
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City | SILVER SPRING
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State | MD
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Zip | 20904-6146
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Country | US
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Telephone | 404-477-8534
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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 | A00177833
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License Number State | MD
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