Provider Demographics
NPI:1437560018
Name:ADAMS, JEWEL FUNYI
Entity Type:Individual
Prefix:
First Name:JEWEL
Middle Name:FUNYI
Last Name:ADAMS
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 1:1101 NALLEY RD APT 1027
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4421
Mailing Address - Country:US
Mailing Address - Phone:240-495-8901
Mailing Address - Fax:
Practice Address - Street 1:1101 NALLEY RD APT 1027
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-4421
Practice Address - Country:US
Practice Address - Phone:240-495-8901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-16
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA4958374U00000X
WAHHA4958251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No251E00000XAgenciesHome Health