Provider Demographics
NPI:1528303831
Name:KEITA, FATIMA
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:KEITA
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 1:6156 SPRINGHILL TER # 3201
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3124
Mailing Address - Country:US
Mailing Address - Phone:301-586-7290
Mailing Address - Fax:
Practice Address - Street 1:6156 SPRINGHILL TER # 3201
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3124
Practice Address - Country:US
Practice Address - Phone:301-586-7290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide