Healthcare Provider Details

I. General information

NPI: 1003744095
Provider Name (Legal Business Name): MRS. DEIDRA ANTOINETTE FORTE'
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6858 WALKER MILL RD APT 201
CAPITOL HEIGHTS MD
20743-7551
US

IV. Provider business mailing address

6858 WALKER MILL RD APT 201
CAPITOL HEIGHTS MD
20743-7551
US

V. Phone/Fax

Practice location:
  • Phone: 202-790-9427
  • Fax:
Mailing address:
  • Phone: 202-790-9427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: