Provider Demographics
NPI:1487297727
Name:IDOWU, ABIMBOLA OLUWAKEMI (HHA)
Entity type:Individual
Prefix:
First Name:ABIMBOLA
Middle Name:OLUWAKEMI
Last Name:IDOWU
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 WHITFIELD CHAPEL RD APT 301
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2542
Mailing Address - Country:US
Mailing Address - Phone:347-785-0171
Mailing Address - Fax:
Practice Address - Street 1:5602 WHITFIELD CHAPEL RD APT 301
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2542
Practice Address - Country:US
Practice Address - Phone:347-785-0171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14577374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide