Provider Demographics
NPI:1316552953
Name:UWAHEMU, JESSICA
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:UWAHEMU
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 1:9727 MOUNT PISGAH RD APT T1
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2000
Mailing Address - Country:US
Mailing Address - Phone:240-595-8366
Mailing Address - Fax:
Practice Address - Street 1:9727 MOUNT PISGAH RD APT T1
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2000
Practice Address - Country:US
Practice Address - Phone:240-595-8366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC276566217Medicaid