Provider Demographics
NPI:1669082707
Name:ENI, PATRICIA ORUKWE (HOME HEALTH AID)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ORUKWE
Last Name:ENI
Suffix:
Gender:F
Credentials:HOME HEALTH AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6115 HILLMEADE RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4654
Mailing Address - Country:US
Mailing Address - Phone:240-688-8740
Mailing Address - Fax:
Practice Address - Street 1:6115 HILLMEADE RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4654
Practice Address - Country:US
Practice Address - Phone:240-688-8740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14779374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide