Healthcare Provider Details

I. General information

NPI: 1669335899
Provider Name (Legal Business Name): NATHANIEL BECKHAM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 CROFFUT PL SE
WASHINGTON DC
20019-2437
US

IV. Provider business mailing address

3300 CROFFUT PL SE
WASHINGTON DC
20019-2437
US

V. Phone/Fax

Practice location:
  • Phone: 202-817-4356
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: