Provider Demographics
NPI:1477211266
Name:NABELA, CLEMENTINE
Entity Type:Individual
Prefix:
First Name:CLEMENTINE
Middle Name:
Last Name:NABELA
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 1:11439 CHERRY HILL RD APT 302
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3641
Mailing Address - Country:US
Mailing Address - Phone:301-664-3437
Mailing Address - Fax:
Practice Address - Street 1:11439 CHERRY HILL RD APT 302
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3641
Practice Address - Country:US
Practice Address - Phone:301-664-3437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00197963376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide