Provider Demographics
NPI:1144589367
Name:ADIKPETO, CHANTAL ATTIGNON II (HHA)
Entity Type:Individual
Prefix:MRS
First Name:CHANTAL
Middle Name:ATTIGNON
Last Name:ADIKPETO
Suffix:II
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 DRUM AVE
Mailing Address - Street 2:520 DRUM AVE
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-2823
Mailing Address - Country:US
Mailing Address - Phone:202-689-4635
Mailing Address - Fax:301-841-7704
Practice Address - Street 1:520 DRUM AVE
Practice Address - Street 2:520 DRUM AVE
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-2823
Practice Address - Country:US
Practice Address - Phone:202-689-4635
Practice Address - Fax:301-841-7704
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC136234374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide