Provider Demographics
NPI:1396501284
Name:KWIZERA, CHIOMA BEAUTY (RN)
Entity type:Individual
Prefix:
First Name:CHIOMA
Middle Name:BEAUTY
Last Name:KWIZERA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 HICKORY HILL CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5807
Mailing Address - Country:US
Mailing Address - Phone:720-989-9860
Mailing Address - Fax:
Practice Address - Street 1:13 HICKORY HILL CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-5807
Practice Address - Country:US
Practice Address - Phone:720-989-9860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376K00000X
MDR292453163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD923147376OtherIRS