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General NPI Number Information
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NPI Number | 1033511969
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Entity Type | Individual
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Provider Name | SHAWNTA ARMSTEAD
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Gender | Female
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Dates
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Enumeration Date | 09/23/2014
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Last Update Date | 09/23/2014
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Provider Practice Location Address
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Address Line | 6120 KANSAS AVE NE
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City | WASHINGTON
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State | DC
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Zip | 20011-1531
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Country | US
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Telephone | 202-722-7776
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Fax |
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Provider Business Mailing Address
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Address Line | 6411 HIL MAR DR APT 304
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City | DISTRICT HEIGHTS
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State | MD
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Zip | 20747-4033
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Country | US
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Telephone | 301-433-5797
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | HHA7462
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License Number State | DC
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