Provider Demographics
NPI:1932765096
Name:MOSERI, PATIENCE CHINWE
Entity Type:Individual
Prefix:
First Name:PATIENCE
Middle Name:CHINWE
Last Name:MOSERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11114 LAKE VICTORIA LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4258
Mailing Address - Country:US
Mailing Address - Phone:240-486-4793
Mailing Address - Fax:
Practice Address - Street 1:11114 LAKE VICTORIA LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4258
Practice Address - Country:US
Practice Address - Phone:240-486-4793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14464374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB200676115770OtherNPI