Provider Demographics
NPI:1750624359
Name:NDIKUM, ROSE BIH (HHA)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:BIH
Last Name:NDIKUM
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3565 LAUREL FORT MEADE RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2010
Mailing Address - Country:US
Mailing Address - Phone:202-545-0935
Mailing Address - Fax:202-545-0176
Practice Address - Street 1:3565 LAUREL FORT MEADE RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2010
Practice Address - Country:US
Practice Address - Phone:202-545-0935
Practice Address - Fax:202-545-0176
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide