Provider Demographics
NPI:1003463985
Name:RANDOLPH, DAYNICA BRIONA
Entity Type:Individual
Prefix:
First Name:DAYNICA
Middle Name:BRIONA
Last Name:RANDOLPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 BRANDYWINE ST SE APT B3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3554
Mailing Address - Country:US
Mailing Address - Phone:202-336-2086
Mailing Address - Fax:
Practice Address - Street 1:3330 ELY PL SE APT 103
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2352
Practice Address - Country:US
Practice Address - Phone:202-704-4971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-24
Last Update Date:2019-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant