MEDICARE: JANICE YVONNE EASTERWOOD

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		DC

General Provider Information

NPI Number	:	1760743595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE YVONNE EASTERWOOD

Provider Business Mailing Address
First Line	:	1230 PENN ST NE
Second Line	:	APT#4
City	:	WASHINGTON
State	:	DC
Zip	:	20002-2810
Country	:	US
Telephone Number	:	202-270-2656
Fax Number	:

Provider Business Practice Location Address
First Line	:	1230 PENN ST NE
Second Line	:	APT#4
City	:	WASHINGTON
State	:	DC
Zip	:	20002-2810
Country	:	US
Telephone Number	:	202-270-2656
Fax Number	:

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

Provider Enumeration Date	:	06/07/2012
Last Update Date	:	07/21/2022

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