Healthcare Provider Details

I. General information

NPI: 1114446614
Provider Name (Legal Business Name): MICHELE S NIANTCHO YOTCHOU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2017
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 PENNSYLVANIA AVE SE
WASHINGTON DC
20020-3865
US

IV. Provider business mailing address

1319 HOLBROOK ST NE APT 3
WASHINGTON DC
20002-3959
US

V. Phone/Fax

Practice location:
  • Phone: 202-894-6811
  • Fax:
Mailing address:
  • Phone: 913-710-7174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA13075
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: