Provider Demographics
NPI:1275013559
Name:ADEKALU, ANTHONIA
Entity Type:Individual
Prefix:
First Name:ANTHONIA
Middle Name:
Last Name:ADEKALU
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 1:1122 21ST ST NE APT 106
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3158
Mailing Address - Country:US
Mailing Address - Phone:202-840-0542
Mailing Address - Fax:
Practice Address - Street 1:1122 21ST ST NE APT 106
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3158
Practice Address - Country:US
Practice Address - Phone:202-840-0542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13931374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC70921908OtherAMERIHEALTH