Provider Demographics
NPI:1902437494
Name:MELESE, MUSELEHA
Entity Type:Individual
Prefix:
First Name:MUSELEHA
Middle Name:
Last Name:MELESE
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 1:12630 VEIRS MILL RD APT 712
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-3570
Mailing Address - Country:US
Mailing Address - Phone:301-526-1541
Mailing Address - Fax:
Practice Address - Street 1:12630 VEIRS MILL RD APT 712
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-3570
Practice Address - Country:US
Practice Address - Phone:301-526-1541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14776374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide