Provider Demographics
NPI:1245591536
Name:NUFOR, ROSELINE
Entity Type:Individual
Prefix:
First Name:ROSELINE
Middle Name:
Last Name:NUFOR
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 1:4536 AMMENDALE RD
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1112
Mailing Address - Country:US
Mailing Address - Phone:202-247-6156
Mailing Address - Fax:
Practice Address - Street 1:4536 AMMENDALE RD
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1112
Practice Address - Country:US
Practice Address - Phone:202-247-6156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-03
Last Update Date:2012-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health