| K&i Healthcare Services | |
|
11637 Terrace Dr Ste 201 Waldorf MD 20602-3708 | |
| (240) 419-3803 | |
| (240) 419-2931 |
| Full Name | K&i Healthcare Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 11637 Terrace Dr Ste 201, Waldorf, Maryland |
| Authorized Official Name and Position | Kelvinda Kamara (NURSE PRACTITIONER) |
| Authorized Official Contact | 2406199180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| K&i Healthcare Services 11637 Terrace Dr Ste 201 Waldorf MD 20602-3708 Ph: (240) 419-3803 | K&i Healthcare Services 11637 Terrace Dr Ste 201 Waldorf MD 20602-3708 Ph: (240) 419-3803 |
| NPI Number | 1407409477 |
|---|---|
| Provider Enumeration Date | 07/18/2019 |
| Last Update Date | 07/26/2023 |
| Certification Date | 07/26/2023 |
| Medicare PECOS PAC ID | 5193131126 |
|---|---|
| Medicare Enrollment ID | O20210317000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407409477 | NPI | - | NPPES |
| 1851641955 | Other | NPI | |
| 059076500 | Medicaid | MD |
| Provider Name | Kelvinda Kamara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851641955 PECOS PAC ID: 6002050481 Enrollment ID: I20130925000575 |
| Provider Name | Ella Louise Tressler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437730959 PECOS PAC ID: 9335548817 Enrollment ID: I20210603002001 |
| Provider Name | Ikechukwu Obiora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598418956 PECOS PAC ID: 5496162828 Enrollment ID: I20220428000075 |
| Provider Name | Frida Fru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447511167 PECOS PAC ID: 9830587880 Enrollment ID: I20221020001748 |
| Provider Name | Diane Lyn Gordon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477692937 PECOS PAC ID: 7113093667 Enrollment ID: I20230821003084 |
| Provider Name | Ugonma P Nwokorie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154091767 PECOS PAC ID: 1759768641 Enrollment ID: I20240129004249 |
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