Provider Demographics
NPI:1518227685
Name:ACHOH, ROSE (LPN)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:ACHOH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11340 EVANS TRL APT T4
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3021
Mailing Address - Country:US
Mailing Address - Phone:240-898-5503
Mailing Address - Fax:
Practice Address - Street 1:11340 EVANS TRL APT T4
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3021
Practice Address - Country:US
Practice Address - Phone:240-898-5503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1006435164W00000X
DCHHA9295374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No164W00000XNursing Service ProvidersLicensed Practical Nurse