Provider Demographics
NPI:1205193844
Name:WIREDUA, HENRIETTA YAA
Entity Type:Individual
Prefix:
First Name:HENRIETTA
Middle Name:YAA
Last Name:WIREDUA
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 1:11644 LOCKWOOD DR
Mailing Address - Street 2:APT 201
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2346
Mailing Address - Country:US
Mailing Address - Phone:240-413-4889
Mailing Address - Fax:
Practice Address - Street 1:11644 LOCKWOOD DR
Practice Address - Street 2:APT 201
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2346
Practice Address - Country:US
Practice Address - Phone:240-413-4889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide