Provider Demographics
NPI:1992065403
Name:KAZEEM, BILIKIS MOSUNMOKA
Entity type:Individual
Prefix:
First Name:BILIKIS
Middle Name:MOSUNMOKA
Last Name:KAZEEM
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 1:7235 CARRIAGE HILL DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5369
Mailing Address - Country:US
Mailing Address - Phone:240-704-5279
Mailing Address - Fax:
Practice Address - Street 1:7235 CARRIAGE HILL DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5369
Practice Address - Country:US
Practice Address - Phone:240-704-5279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDK250089609409374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide