Provider Demographics
NPI:1619850807
Name:BAKARE, MARIE CLAUDE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:CLAUDE
Last Name:BAKARE
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 1:15355 GATEHOUSE TER
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-4130
Mailing Address - Country:US
Mailing Address - Phone:703-338-3654
Mailing Address - Fax:
Practice Address - Street 1:15355 GATEHOUSE TER
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-4130
Practice Address - Country:US
Practice Address - Phone:703-338-3654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA14010228094376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty