Provider Demographics
NPI:1588472856
Name:TEKU EPOUSE TEPI, ADELINE AJEM
Entity type:Individual
Prefix:
First Name:ADELINE
Middle Name:AJEM
Last Name:TEKU EPOUSE TEPI
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 1:7607 OXMAN RD
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-3420
Mailing Address - Country:US
Mailing Address - Phone:240-461-4970
Mailing Address - Fax:
Practice Address - Street 1:7607 OXMAN RD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-3420
Practice Address - Country:US
Practice Address - Phone:240-461-4970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide