Healthcare Provider Details

I. General information

NPI: 1831806462
Provider Name (Legal Business Name): RENEE PARKER I CAREGIVER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2022
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2027 R ST SE
WASHINGTON DC
20020-4624
US

IV. Provider business mailing address

2027 R ST SE
WASHINGTON DC
20020-4624
US

V. Phone/Fax

Practice location:
  • Phone: 202-710-7135
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code156FX1900X
TaxonomyOrthoptist
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: