Individual
MRS. CLAUDETTE EMMELINE DEMETRIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16220 FREDRICK AVE, #12, GEITHERSBERG, MD 20877
(301) 208-0775
Mailing address
13529 GEORGIA AVE, APARTMENT 203, SILVER SPRING, MD 20906
(301) 946-3338
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
A00015852
MD
374U00000X
Home Health Aide
Primary
991558
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4387007-00
MEDICAL ASSISTANCE
MD
05
—
714564100
—
MD
01
—
A00015852
CERTIFIED GERIATRIC NURSE
MD
Enumeration date
12/15/2006
Last updated
02/27/2012
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