Provider Demographics
NPI:1144194440
Name:BOUDA BATAKO, KATIANA
Entity type:Individual
Prefix:
First Name:KATIANA
Middle Name:
Last Name:BOUDA BATAKO
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 1:8504 16TH ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2968
Mailing Address - Country:US
Mailing Address - Phone:202-570-8118
Mailing Address - Fax:
Practice Address - Street 1:8504 16TH ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2968
Practice Address - Country:US
Practice Address - Phone:202-570-8118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200005462374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide