Provider Demographics
NPI:1205416914
Name:TIKU, MAUREEN NWANJEH
Entity Type:Individual
Prefix:
First Name:MAUREEN NWANJEH
Middle Name:
Last Name:TIKU
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 1:9812 PEMBROKE DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-1576
Mailing Address - Country:US
Mailing Address - Phone:240-500-6869
Mailing Address - Fax:
Practice Address - Street 1:9812 PEMBROKE DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-1576
Practice Address - Country:US
Practice Address - Phone:240-500-6869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide