Provider Demographics
NPI:1619236544
Name:KEHBILA, CLAUDIA B
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:B
Last Name:KEHBILA
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 1:5021 TOWNSEND WAY APT C#3
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1137
Mailing Address - Country:US
Mailing Address - Phone:240-330-3548
Mailing Address - Fax:
Practice Address - Street 1:3313 CHILLUM RD
Practice Address - Street 2:APT # 203
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-1137
Practice Address - Country:US
Practice Address - Phone:240-330-3548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-12
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA3514374U00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide