Provider Demographics
NPI:1588093967
Name:AVUDUFU, AKOSSIWA (HHA)
Entity type:Individual
Prefix:
First Name:AKOSSIWA
Middle Name:
Last Name:AVUDUFU
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 1:5911 CHERRYWOOD TER
Mailing Address - Street 2:APT.103
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3142
Mailing Address - Country:US
Mailing Address - Phone:240-898-6541
Mailing Address - Fax:
Practice Address - Street 1:5911 CHERRYWOOD TER
Practice Address - Street 2:APT.103
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3142
Practice Address - Country:US
Practice Address - Phone:240-898-6541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide