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NPI Code Detail

MEDICARE: KHALIFATU O FAWEHINMI

MEDICARE: KHALIFATU O FAWEHINMI
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
1164W00000XLicensed Practical NurseLPN46835MD

General Provider Information

NPI Number : 1790345809
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHALIFATU O FAWEHINMI
Provider Business Mailing Address
First Line : 656 CHARANTE CT APT 104
Second Line :
City : GLEN BURNIE
State : MD
Zip : 21061-5198
Country : US
Telephone Number : 240-475-5096
Fax Number :
Provider Business Practice Location Address
First Line : 3298 FORT LINCOLN DR NE APT 1010
Second Line :
City : WASHINGTON
State : DC
Zip : 20018-4342
Country : US
Telephone Number : 240-475-5096
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2019
Last Update Date : 06/20/2019

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Directions to “ KHALIFATU O FAWEHINMI ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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