Healthcare Provider Details

I. General information

NPI: 1699235168
Provider Name (Legal Business Name): MRS. ROSANE ST PAUL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MAINE AVE SW STE 200
WASHINGTON DC
20024-2811
US

IV. Provider business mailing address

800 MAINE AVE SW STE 200
WASHINGTON DC
20024-2811
US

V. Phone/Fax

Practice location:
  • Phone: 202-660-1460
  • Fax: 202-660-1460
Mailing address:
  • Phone: 202-660-1460
  • Fax: 202-660-1460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: