MEDICARE: MIREILLE TCHANA

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	374U00000X	Home Health Aide	HHA13180	DC

General Provider Information

NPI Number	:	1619480043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIREILLE TCHANA

Provider Business Mailing Address
First Line	:	11700 OLD COLUMBIA PIKE APT 1415
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2556
Country	:	US
Telephone Number	:	240-513-0955
Fax Number	:

Provider Business Practice Location Address
First Line	:	11700 OLD COLUMBIA PIKE APT 1415
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2556
Country	:	US
Telephone Number	:	240-513-0955
Fax Number	:

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

Provider Enumeration Date	:	11/07/2017
Last Update Date	:	11/07/2017

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Directions to “ MIREILLE TCHANA ” Practice Location

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