Provider Demographics
NPI:1922663079
Name:NKEH, ODILIA BEMEHBONUI
Entity type:Individual
Prefix:
First Name:ODILIA
Middle Name:BEMEHBONUI
Last Name:NKEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13104 LOCKWOODS PROGRESS DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-6319
Mailing Address - Country:US
Mailing Address - Phone:240-413-0103
Mailing Address - Fax:
Practice Address - Street 1:13104 LOCKWOODS PROGRESS DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-6319
Practice Address - Country:US
Practice Address - Phone:240-413-0103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14383374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide