Provider Demographics
NPI:1083287486
Name:UMUNNA-UDOH, NKEMKA (RN,BSN)
Entity Type:Individual
Prefix:
First Name:NKEMKA
Middle Name:
Last Name:UMUNNA-UDOH
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13009 GOLDEN OAK DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2331
Mailing Address - Country:US
Mailing Address - Phone:202-315-8302
Mailing Address - Fax:
Practice Address - Street 1:13009 GOLDEN OAK DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-2331
Practice Address - Country:US
Practice Address - Phone:202-315-8302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR5003163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health