Provider Demographics
NPI:1134482433
Name:CHE, EMELDA MATI
Entity Type:Individual
Prefix:
First Name:EMELDA
Middle Name:MATI
Last Name:CHE
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 1:10450 LOTTSFORD RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2734
Mailing Address - Country:US
Mailing Address - Phone:301-925-7707
Mailing Address - Fax:
Practice Address - Street 1:7600 GEORGIA AVE NW
Practice Address - Street 2:SUITE 323
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1616
Practice Address - Country:US
Practice Address - Phone:202-723-3050
Practice Address - Fax:202-723-3065
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2021-10-25
Deactivation Date:2021-07-22
Deactivation Code:
Reactivation Date:2021-10-20
Provider Licenses
StateLicense IDTaxonomies
DCRN1024577163WH0200X
MDR197388363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH0200XNursing Service ProvidersRegistered NurseHome Health