Provider Demographics
NPI:1649742388
Name:ABDELLA, KADIJA
Entity Type:Individual
Prefix:
First Name:KADIJA
Middle Name:
Last Name:ABDELLA
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 1:9252 PINEY BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2835
Mailing Address - Country:US
Mailing Address - Phone:240-839-8692
Mailing Address - Fax:
Practice Address - Street 1:9252 PINEY BRANCH RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2835
Practice Address - Country:US
Practice Address - Phone:240-839-8692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14140374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide