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NPI Code Detail

MEDICARE: JACQUELINE PATRICIA PICKETT

MEDICARE: JACQUELINE PATRICIA PICKETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1053277764
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE PATRICIA PICKETT
Provider Business Mailing Address
First Line : 6457 PENNSYLVANIA AVE APT 203
Second Line :
City : DISTRICT HEIGHTS
State : MD
Zip : 20747-3026
Country : US
Telephone Number : 240-838-2167
Fax Number :
Provider Business Practice Location Address
First Line : 6457 PENNSYLVANIA AVE APT 203
Second Line : APT 203
City : DISTRICT HEIGHTS
State : MD
Zip : 20747-3026
Country : US
Telephone Number : 240-838-2167
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2025
Last Update Date : 12/27/2025

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Directions to “ JACQUELINE PATRICIA PICKETT ” Practice Location

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