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General NPI Number Information
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NPI Number | 1649462755
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Entity Type | Individual
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Provider Name | LAQUANDRA SHERESE NESBITT MD, MPH
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Gender | Female
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 899 N CAPITOL ST NE 5TH FLOOR
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City | WASHINGTON
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State | DC
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Zip | 20002-4263
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Country | US
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Telephone | 202-442-5955
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Fax |
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Provider Business Mailing Address
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Address Line | 899 N CAPITOL ST NE 5TH FLOOR
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City | WASHINGTON
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State | DC
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Zip | 20002-4263
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Country | US
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Telephone | 202-442-5955
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0063089
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 45081
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD038198
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License Number State | DC
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