Provider Demographics
NPI:1225593742
Name:AMZAT, FELICIA IBIDUN
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:IBIDUN
Last Name:AMZAT
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 1:3233 75TH AVE APT 304
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1926
Mailing Address - Country:US
Mailing Address - Phone:240-441-0264
Mailing Address - Fax:
Practice Address - Street 1:3627 HORNER PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2476
Practice Address - Country:US
Practice Address - Phone:240-595-0751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No251E00000XAgenciesHome Health