Provider Demographics
NPI:1386280790
Name:NITCHEW, HONICLIFF
Entity type:Individual
Prefix:
First Name:HONICLIFF
Middle Name:
Last Name:NITCHEW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15241 PALO PINTO DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-5558
Mailing Address - Country:US
Mailing Address - Phone:301-873-3168
Mailing Address - Fax:
Practice Address - Street 1:15241 PALO PINTO DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5558
Practice Address - Country:US
Practice Address - Phone:301-873-3168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide