Healthcare Provider Details

I. General information

NPI: 1407287675
Provider Name (Legal Business Name): MISS ANGELA HINNANT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2013
Last Update Date: 12/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 WISCONSIN AVE NW SUITE 250
WASHINGTON DC
20016-4120
US

IV. Provider business mailing address

4114 1ST ST SE
WASHINGTON DC
20032-2822
US

V. Phone/Fax

Practice location:
  • Phone: 202-526-2400
  • Fax:
Mailing address:
  • Phone: 202-779-6345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA9739
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: