Provider Demographics
NPI:1154858835
Name:OMULAR, ROSELINE CHINYERE
Entity type:Individual
Prefix:MS
First Name:ROSELINE
Middle Name:CHINYERE
Last Name:OMULAR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 LEMONTREE TER
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20774-7540
Mailing Address - Country:US
Mailing Address - Phone:202-617-8881
Mailing Address - Fax:
Practice Address - Street 1:2503 LEMONTREE TER
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:MD
Practice Address - Zip Code:20774-7540
Practice Address - Country:US
Practice Address - Phone:202-617-8881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-12
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12739374U00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide