Provider Demographics
NPI:1003602046
Name:LOKENDO ILUE, MAGDALINE
Entity type:Individual
Prefix:
First Name:MAGDALINE
Middle Name:
Last Name:LOKENDO ILUE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6813 SIMMONS LN
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-9720
Mailing Address - Country:US
Mailing Address - Phone:240-796-7386
Mailing Address - Fax:
Practice Address - Street 1:6813 SIMMONS LN
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-9720
Practice Address - Country:US
Practice Address - Phone:240-796-7386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200004883374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide