Provider Demographics
NPI:1235553876
Name:OMOKHOMION, ADENIKE
Entity Type:Individual
Prefix:MISS
First Name:ADENIKE
Middle Name:
Last Name:OMOKHOMION
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 1:3602 EDMOND WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1275
Mailing Address - Country:US
Mailing Address - Phone:301-536-0766
Mailing Address - Fax:
Practice Address - Street 1:3602 EDMOND WAY
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1275
Practice Address - Country:US
Practice Address - Phone:301-536-0766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA10094374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide