Healthcare Provider Details

I. General information

NPI: 1609447663
Provider Name (Legal Business Name): LAWANE TERRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 07/09/2021
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 23RD ST NW
WASHINGTON DC
20037-1282
US

IV. Provider business mailing address

6522 8TH AVE
HYATTSVILLE MD
20783-3106
US

V. Phone/Fax

Practice location:
  • Phone: 202-957-1135
  • Fax:
Mailing address:
  • Phone: 240-676-2868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: