Provider Demographics
NPI:1629652490
Name:MAULIDI, HABIBA DJUMAPILI
Entity Type:Individual
Prefix:
First Name:HABIBA
Middle Name:DJUMAPILI
Last Name:MAULIDI
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 1:18444 N 25TH AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-1268
Mailing Address - Country:US
Mailing Address - Phone:480-534-0605
Mailing Address - Fax:
Practice Address - Street 1:18444 N 25TH AVE STE 420
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-1268
Practice Address - Country:US
Practice Address - Phone:480-534-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No171W00000XOther Service ProvidersContractor
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1255915344OtherNPI