Provider Demographics
NPI:1306401385
Name:UKAOMA, KELECHI LYNDA
Entity Type:Individual
Prefix:
First Name:KELECHI
Middle Name:LYNDA
Last Name:UKAOMA
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 1:1519 HEATHER HOLLOW CIR APT 22
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2385
Mailing Address - Country:US
Mailing Address - Phone:301-272-5229
Mailing Address - Fax:
Practice Address - Street 1:1519 HEATHER HOLLOW CIR APT 22
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2385
Practice Address - Country:US
Practice Address - Phone:301-272-5229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14428374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide