Provider Demographics
NPI:1063774099
Name:ABERDEEN, AMINA ABENA
Entity type:Individual
Prefix:
First Name:AMINA
Middle Name:ABENA
Last Name:ABERDEEN
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 1:2110 BROOKS DR
Mailing Address - Street 2:511
Mailing Address - City:FORESTVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1064
Mailing Address - Country:US
Mailing Address - Phone:301-806-9670
Mailing Address - Fax:
Practice Address - Street 1:2110 BROOKS DR
Practice Address - Street 2:511
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747-1064
Practice Address - Country:US
Practice Address - Phone:301-806-9670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA4373374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide