MEDICARE: RONJAI MICHELLE BECKWITH

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		DC

General Provider Information

NPI Number	:	1700457736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONJAI MICHELLE BECKWITH

Provider Business Mailing Address
First Line	:	2801 POMEROY RD SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3298 FORT LINCOLN DR NE APT 224
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-4306
Country	:	US
Telephone Number	:	202-629-6971
Fax Number	:

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

Provider Enumeration Date	:	07/09/2021
Last Update Date	:	07/09/2021

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