Provider Demographics
NPI:1669748828
Name:CHE, DURREL (HHA)
Entity type:Individual
Prefix:
First Name:DURREL
Middle Name:
Last Name:CHE
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4812 LAKE ONTARIO WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3695
Mailing Address - Country:US
Mailing Address - Phone:240-643-0128
Mailing Address - Fax:
Practice Address - Street 1:4812 LAKE ONTARIO WAY
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3695
Practice Address - Country:US
Practice Address - Phone:240-643-0128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-31
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1059914163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health