Provider Demographics
NPI:1740762574
Name:UMERAH, CHINWE DORATHY
Entity Type:Individual
Prefix:
First Name:CHINWE
Middle Name:DORATHY
Last Name:UMERAH
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 1:2120 COUNTY RD APT 102
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1337
Mailing Address - Country:US
Mailing Address - Phone:240-714-1516
Mailing Address - Fax:
Practice Address - Street 1:2120 COUNTY RD APT 102
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-1337
Practice Address - Country:US
Practice Address - Phone:240-714-1516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide