MEDICARE: MRS. OLASUMBO AKINYEMI HHA

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	HHA7640	DC

General Provider Information

NPI Number	:	1841638426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. OLASUMBO AKINYEMI HHA

Provider Business Mailing Address
First Line	:	3221 75TH AVENUE
Second Line	:	404
City	:	HYATTSVILLE
State	:	MD - MARYLAND
Zip	:	20785
Country	:	UM
Telephone Number	:	301-267-3720
Fax Number	:

Provider Business Practice Location Address
First Line	:	3221 75TH AVE
Second Line	:	404
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-1915
Country	:	US
Telephone Number	:	301-267-3720
Fax Number	:

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

Provider Enumeration Date	:	06/05/2013
Last Update Date	:	06/05/2013

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