Provider Demographics
NPI:1962977751
Name:AKINKUGBE, ROTIMI D (HHA)
Entity type:Individual
Prefix:
First Name:ROTIMI
Middle Name:D
Last Name:AKINKUGBE
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5604 WHITFIELD CHAPEL RD APT 303
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2543
Mailing Address - Country:US
Mailing Address - Phone:240-386-9313
Mailing Address - Fax:
Practice Address - Street 1:5604 WHITFIELD CHAPEL RD APT 303
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2543
Practice Address - Country:US
Practice Address - Phone:240-386-9313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14027374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide