Provider Demographics
NPI:1003515073
Name:CORTEZ, MARIA DE JESUS
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DE JESUS
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:DE JESUS
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1320 NICHOLSON ST NW APT 108
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-2801
Mailing Address - Country:US
Mailing Address - Phone:240-556-3526
Mailing Address - Fax:
Practice Address - Street 1:1629 COLUMBIA RD NW APT 505
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-3645
Practice Address - Country:US
Practice Address - Phone:202-848-2607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant