Provider Demographics
NPI:1124991286
Name:DIKUBA, PATIENCE
Entity type:Individual
Prefix:
First Name:PATIENCE
Middle Name:
Last Name:DIKUBA
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 1:793 QUINCE ORCHARD BLVD APT 23
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1640
Mailing Address - Country:US
Mailing Address - Phone:240-715-7654
Mailing Address - Fax:
Practice Address - Street 1:793 QUINCE ORCHARD BLVD APT 23
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1640
Practice Address - Country:US
Practice Address - Phone:240-715-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN500125342163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse