Provider Demographics
NPI:1235714866
Name:UMEH, ANDRA
Entity Type:Individual
Prefix:MS
First Name:ANDRA
Middle Name:
Last Name:UMEH
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 1:1244 CRESTHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1103
Mailing Address - Country:US
Mailing Address - Phone:301-332-2501
Mailing Address - Fax:301-434-1938
Practice Address - Street 1:1244 CRESTHAVEN DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1103
Practice Address - Country:US
Practice Address - Phone:301-332-2501
Practice Address - Fax:301-434-1938
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR4568311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home