MEDICARE: LORNA SIPOWA QUISUH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1265878227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORNA SIPOWA QUISUH

Provider Business Mailing Address
First Line	:	11502 LOCKWOOD DR APT B1
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2404
Country	:	US
Telephone Number	:	240-468-0396
Fax Number	:

Provider Business Practice Location Address
First Line	:	11502 LOCKWOOD DR APT B1
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2404
Country	:	US
Telephone Number	:	240-468-0396
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2013
Last Update Date	:	05/17/2013

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Directions to “ LORNA SIPOWA QUISUH ” Practice Location

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