Provider Demographics
NPI:1033973110
Name:EDWARDS, ATIYA IMANI
Entity Type:Individual
Prefix:
First Name:ATIYA
Middle Name:IMANI
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ATIYA
Other - Middle Name:IMANI
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:716 12TH ST SE # 37009TH
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2969
Mailing Address - Country:US
Mailing Address - Phone:202-446-9481
Mailing Address - Fax:
Practice Address - Street 1:716 12TH ST SE APT 22
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2969
Practice Address - Country:US
Practice Address - Phone:301-383-4332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide