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General NPI Number Information
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NPI Number | 1124477096
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Entity Type | Organization
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Legal Business Name | DISTRICT PRIMARY CARE, LLC
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Dates
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Enumeration Date | 06/10/2016
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 700 PENNSYLVANIA AVE SE FL 2
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City | WASHINGTON
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State | DC
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Zip | 20003-2493
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Country | US
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Telephone | 202-446-1085
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Fax | 202-446-1086
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Provider Business Mailing Address
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Address Line | 215 C ST SE APT 504
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City | WASHINGTON
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State | DC
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Zip | 20003-1947
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Country | US
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Telephone | 202-446-0185
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Fax | 202-446-1086
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. WESLEY E COOK
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Credential | DNP, APRN
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Telephone | 202-446-1085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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