Provider Demographics
NPI:1598026361
Name:OSHIBERU, JOLOMI
Entity Type:Individual
Prefix:
First Name:JOLOMI
Middle Name:
Last Name:OSHIBERU
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 1:11903 BRISTOLWOOD TER
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-3185
Mailing Address - Country:US
Mailing Address - Phone:301-533-8850
Mailing Address - Fax:
Practice Address - Street 1:11903 BRISTOLWOOD TER
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-3185
Practice Address - Country:US
Practice Address - Phone:301-533-8850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide