Healthcare Provider Details

I. General information

NPI: 1003773979
Provider Name (Legal Business Name): BEATRICE JEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 GEORGIA AVE NW STE 323
WASHINGTON DC
20012-1616
US

IV. Provider business mailing address

7600 GEORGIA AVE NW STE 323
WASHINGTON DC
20012-1616
US

V. Phone/Fax

Practice location:
  • Phone: 240-474-6678
  • Fax:
Mailing address:
  • Phone: 240-474-6678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN1008344
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: