MEDICARE: AFRICA LYNN RAYNIECE NESBITT-GAINES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1245187939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AFRICA LYNN RAYNIECE NESBITT-GAINES

Provider Business Mailing Address
First Line	:	3737 SEMINARY RD # SM104
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-5202
Country	:	US
Telephone Number	:	240-723-7048
Fax Number	:

Provider Business Practice Location Address
First Line	:	3737 SEMINARY RD # SM104
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22304-5202
Country	:	US
Telephone Number	:	240-723-7048
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	04/06/2026

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