Healthcare Provider Details

I. General information

NPI: 1417894304
Provider Name (Legal Business Name): NATOSHA HINES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 JAY ST NE
WASHINGTON DC
20019-4895
US

IV. Provider business mailing address

2315 ALTAMONT PL SE APT 3
WASHINGTON DC
20020-4150
US

V. Phone/Fax

Practice location:
  • Phone: 240-508-9799
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: