Provider Demographics
NPI:1003432014
Name:PRIMARY CARE AT HOME
Entity Type:Organization
Organization Name:PRIMARY CARE AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BYAM
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:202-642-1435
Mailing Address - Street 1:5614 CONNECTICUT AVE NW # 286
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:323-334-1443
Practice Address - Street 1:5614 CONNECTICUT AVE NW # 286
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2604
Practice Address - Country:US
Practice Address - Phone:202-870-2637
Practice Address - Fax:323-334-1443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-25
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1588954234Medicaid