1598011850 NPI number — JEANNE TALEKE UTEMESI ALBERO NURSE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598011850 NPI number — JEANNE TALEKE UTEMESI ALBERO NURSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UTEMESI ALBERO
Provider First Name:
JEANNE
Provider Middle Name:
TALEKE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NURSE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
UTEMESI ALBERO
Provider Other First Name:
JEANNE
Provider Other Middle Name:
TALEKE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1598011850
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8839 STONEBROOK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21046-1415
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-701-0096
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9951 GOOD LUCK RD
Provider Second Line Business Practice Location Address:
APT T3
Provider Business Practice Location Address City Name:
LANHAM
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20706-3268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-701-0096
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 164W00000X , with the licence number:  LP45241 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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