Provider Demographics
NPI:1467798330
Name:ABDULHAMID, JENISE V (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JENISE
Middle Name:V
Last Name:ABDULHAMID
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:JENISE
Other - Middle Name:VICTORIA
Other - Last Name:ABDULHAMID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE
Mailing Address - Street 1:7031 BOLELYN WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-7277
Mailing Address - Country:US
Mailing Address - Phone:804-909-9600
Mailing Address - Fax:
Practice Address - Street 1:7031 BOLELYN WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-7277
Practice Address - Country:US
Practice Address - Phone:804-909-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002082259251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health