Provider Demographics
NPI:1356717318
Name:AKEEBABU, RUKAYAT
Entity type:Individual
Prefix:
First Name:RUKAYAT
Middle Name:
Last Name:AKEEBABU
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 1:115 CROYDON CT APT 8
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4115
Mailing Address - Country:US
Mailing Address - Phone:347-574-8297
Mailing Address - Fax:
Practice Address - Street 1:115 CROYDON CT APT 8
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4115
Practice Address - Country:US
Practice Address - Phone:347-574-8297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11225374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide