NPI Code Details Logo

NPI 1467384792

NPI 1467384792 : PRENTICE HARRIS : WASHINGTON, DC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1467384792
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    PRENTICE HARRIS
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/01/2026
-----------------------------------------------------
    Last Update Date     |    06/01/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    3491 STANTON RD SE 
-----------------------------------------------------
    City                 |    WASHINGTON
-----------------------------------------------------
    State                |    DC
-----------------------------------------------------
    Zip                  |    20020-2283
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    202-805-0210
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    235 MISSISSIPPI AVE SE APT 102 
-----------------------------------------------------
    City                 |    WASHINGTON
-----------------------------------------------------
    State                |    DC
-----------------------------------------------------
    Zip                  |    20032-2468
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    3747P1801X
-----------------------------------------------------
    Taxonomy Name        |    Personal Care Attendant
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.