Provider Demographics
NPI:1437497039
Name:MONEKE, MARYROSE IJEOMA
Entity Type:Individual
Prefix:
First Name:MARYROSE
Middle Name:IJEOMA
Last Name:MONEKE
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 1:8724 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3684
Mailing Address - Country:US
Mailing Address - Phone:240-464-7979
Mailing Address - Fax:
Practice Address - Street 1:8724 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3684
Practice Address - Country:US
Practice Address - Phone:240-464-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide