Provider Demographics
NPI:1497100812
Name:AMUCHIE, JOVITA LEECHI
Entity Type:Individual
Prefix:
First Name:JOVITA
Middle Name:LEECHI
Last Name:AMUCHIE
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 1:1213 NORTHERN LIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-6052
Mailing Address - Country:US
Mailing Address - Phone:240-280-6326
Mailing Address - Fax:
Practice Address - Street 1:1213 NORTHERN LIGHTS DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-6052
Practice Address - Country:US
Practice Address - Phone:240-280-6326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11744374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide