Provider Demographics
NPI:1871161489
Name:AMANA REGINA AKUH EPSE MBUH, FNU
Entity type:Individual
Prefix:
First Name:FNU
Middle Name:
Last Name:AMANA REGINA AKUH EPSE MBUH
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 1:5425 85TH AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4514
Mailing Address - Country:US
Mailing Address - Phone:240-714-9556
Mailing Address - Fax:
Practice Address - Street 1:5425 85TH AVE APT 202
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4514
Practice Address - Country:US
Practice Address - Phone:240-714-9556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDCNA20202868376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide