Provider Demographics
NPI:1154736106
Name:AFOLABI, RACHAEL (CNA)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:AFOLABI
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7608 GEORGIAN DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-4496
Mailing Address - Country:US
Mailing Address - Phone:240-619-0540
Mailing Address - Fax:
Practice Address - Street 1:7608 GEORGIAN DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-4496
Practice Address - Country:US
Practice Address - Phone:240-619-0540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-29
Last Update Date:2014-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNA00809080376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCNA 00809080OtherCNA