Provider Demographics
NPI:1912548785
Name:NAKITENDE, REHEMAH
Entity Type:Individual
Prefix:
First Name:REHEMAH
Middle Name:
Last Name:NAKITENDE
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 1:4 RIVERHURST RD APT 238
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-3488
Mailing Address - Country:US
Mailing Address - Phone:617-275-3292
Mailing Address - Fax:
Practice Address - Street 1:4 RIVERHURST RD APT 238
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-3488
Practice Address - Country:US
Practice Address - Phone:617-275-3292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2314436163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty