Healthcare Provider Details

I. General information

NPI: 1912268855
Provider Name (Legal Business Name): ANGELA TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2012
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1822 JEFFERSON PL NW
WASHINGTON DC
20036-2505
US

IV. Provider business mailing address

7826 EASTERN AVE NW L
WASHINGTON DC
20012-1324
US

V. Phone/Fax

Practice location:
  • Phone: 202-293-2931
  • Fax: 202-293-3480
Mailing address:
  • Phone: 202-722-7776
  • Fax: 202-722-7785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: