Individual
CHISOM ADANNA EGBUCHERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1009 CHILLUM RD, 208, HYATTSVILLE, MD 20782-2265
(301) 543-9879
Mailing address
1009 CHILLUM RD, 208, HYATTSVILLE, MD 20782-2265
(301) 543-9879
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA11682
DC
376K00000X
Nurse's Aide
NA00607511
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HHA11682
HHA LICENSE
DC
01
—
NA00607511
CNA LICENSE
DC
Enumeration date
12/21/2015
Last updated
12/21/2015
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