Provider Demographics
NPI:1134694276
Name:AMOO, ESTHER ODURAA
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:ODURAA
Last Name:AMOO
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 1:10737 TUTTLE LN
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-2803
Mailing Address - Country:US
Mailing Address - Phone:571-299-5599
Mailing Address - Fax:703-594-0224
Practice Address - Street 1:10737 TUTTLE LN
Practice Address - Street 2:
Practice Address - City:BRISTOW
Practice Address - State:VA
Practice Address - Zip Code:20136-2803
Practice Address - Country:US
Practice Address - Phone:571-299-5599
Practice Address - Fax:703-594-0224
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA711343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)