MEDICARE: DENITA LARNET PERRY

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
1	3747P1801X	Personal Care Attendant	246016856174	MD

General Provider Information

NPI Number	:	1295586162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENITA LARNET PERRY

Provider Business Mailing Address
First Line	:	3534 E CAPITOL ST NE APT 403
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-1226
Country	:	US
Telephone Number	:	202-716-0658
Fax Number	:

Provider Business Practice Location Address
First Line	:	3534 E CAPITOL ST NE APT 408
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-1226
Country	:	US
Telephone Number	:	202-704-8922
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2024
Last Update Date	:	04/09/2024

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