MEDICARE: OLORUNWA WHENU

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	HHA10482	DC

General Provider Information

NPI Number	:	1285054262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLORUNWA WHENU

Provider Business Mailing Address
First Line	:	6902 SEAT PLEASANT DR APT 303
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-2419
Country	:	US
Telephone Number	:	240-528-0815
Fax Number	:

Provider Business Practice Location Address
First Line	:	6902 SEAT PLEASANT DR APT 303
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-2419
Country	:	US
Telephone Number	:	240-528-0815
Fax Number	:

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

Provider Enumeration Date	:	04/17/2014
Last Update Date	:	04/17/2014

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