Provider Demographics
NPI:1326607987
Name:CHIBUEZE, PATRICIA IFEYINWA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:IFEYINWA
Last Name:CHIBUEZE
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 1:11844 EDMONT PL
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-4938
Mailing Address - Country:US
Mailing Address - Phone:240-551-2184
Mailing Address - Fax:
Practice Address - Street 1:201 36TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2664
Practice Address - Country:US
Practice Address - Phone:202-398-2198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant