Provider Demographics
NPI:1871335604
Name:CONTEH, FATMATA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:FATMATA
Middle Name:
Last Name:CONTEH
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 MEDICAL CENTER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-3703
Mailing Address - Country:US
Mailing Address - Phone:240-438-1096
Mailing Address - Fax:
Practice Address - Street 1:9500 MEDICAL CENTER DR STE 104
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-3703
Practice Address - Country:US
Practice Address - Phone:240-438-1096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR258323163WM0705X
DCRN500013774163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical