Provider Demographics
NPI:1689178725
Name:KENSO HELGA, BEI DZEKEM
Entity Type:Individual
Prefix:
First Name:BEI DZEKEM
Middle Name:
Last Name:KENSO HELGA
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 1:3213 AMADOR DR
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2448
Mailing Address - Country:US
Mailing Address - Phone:301-326-9729
Mailing Address - Fax:
Practice Address - Street 1:3213 AMADOR DR
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-2448
Practice Address - Country:US
Practice Address - Phone:301-326-9729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13520374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide