Provider Demographics
NPI:1548771009
Name:IBE, DARLINGTON NNAEMEZIE
Entity Type:Individual
Prefix:
First Name:DARLINGTON
Middle Name:NNAEMEZIE
Last Name:IBE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4603 DOCTOR BEANS LEGACY CIR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-6387
Mailing Address - Country:US
Mailing Address - Phone:202-288-3288
Mailing Address - Fax:
Practice Address - Street 1:4603 DOCTOR BEANS LEGACY CIR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-6387
Practice Address - Country:US
Practice Address - Phone:202-288-3288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHHA13186374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDI-100-135-635-012OtherMARYLAND