Provider Demographics
NPI:1366942732
Name:UKUM, LUCIA EYAMBE
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:EYAMBE
Last Name:UKUM
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 1:8805 SHANNAN DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2450
Mailing Address - Country:US
Mailing Address - Phone:202-790-9360
Mailing Address - Fax:
Practice Address - Street 1:8805 SHANNAN DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2450
Practice Address - Country:US
Practice Address - Phone:202-790-9360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide