Provider Demographics
NPI:1376094797
Name:OSAHON, PATIENCE
Entity Type:Individual
Prefix:
First Name:PATIENCE
Middle Name:
Last Name:OSAHON
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 1:5201 SHERIFF RD NE APT 203
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-5583
Mailing Address - Country:US
Mailing Address - Phone:240-615-7024
Mailing Address - Fax:
Practice Address - Street 1:5201 SHERIFF RD NE APT 203
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5583
Practice Address - Country:US
Practice Address - Phone:240-615-7024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA1608374U00000X, 374U00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes374U00000XNursing Service Related ProvidersHome Health Aide