Provider Demographics
NPI:1083058929
Name:FEKWA, JOSUE (HHA)
Entity Type:Individual
Prefix:
First Name:JOSUE
Middle Name:
Last Name:FEKWA
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 HOLBROOK ST NE APT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2543
Mailing Address - Country:US
Mailing Address - Phone:202-569-0201
Mailing Address - Fax:
Practice Address - Street 1:1651 HOLBROOK ST NE APT 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2543
Practice Address - Country:US
Practice Address - Phone:202-569-0201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide