Healthcare Provider Details

I. General information

NPI: 1578331898
Provider Name (Legal Business Name): DEIONNA ELLERI PRINCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 TRENTON PL SE
WASHINGTON DC
20020-7650
US

IV. Provider business mailing address

2401 MARTIN LUTHER KING JR AVE SE
WASHINGTON DC
20020-5815
US

V. Phone/Fax

Practice location:
  • Phone: 202-415-7817
  • Fax:
Mailing address:
  • Phone: 877-659-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: