Healthcare Provider Details

I. General information

NPI: 1548178742
Provider Name (Legal Business Name): MS. KEISHA DANDRIDGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 JAMES BANK RD SE APT 411
WASHINGTON DC
20020-3744
US

IV. Provider business mailing address

2401 JAMES BANK RD SE APT 411
WASHINGTON DC
20020-3744
US

V. Phone/Fax

Practice location:
  • Phone: 202-430-9388
  • 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: