Provider Demographics
NPI:1003303421
Name:KEBBIE SCHOLZ, GIILEH
Entity Type:Individual
Prefix:
First Name:GIILEH
Middle Name:
Last Name:KEBBIE SCHOLZ
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 1:1908 MAEMOORE CT
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2573
Mailing Address - Country:US
Mailing Address - Phone:301-346-6788
Mailing Address - Fax:
Practice Address - Street 1:1908 MAEMOORE CT
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747-2573
Practice Address - Country:US
Practice Address - Phone:301-346-6788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12097374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide