Provider Demographics
NPI:1083220669
Name:JUAREZ ESCALANTE, IRMA ROSA
Entity Type:Individual
Prefix:
First Name:IRMA
Middle Name:ROSA
Last Name:JUAREZ ESCALANTE
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 1:20818 WALLINGFORD SQ APT 203
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-7390
Mailing Address - Country:US
Mailing Address - Phone:571-577-0063
Mailing Address - Fax:
Practice Address - Street 1:20818 WALLINGFORD SQ APT 203
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-7390
Practice Address - Country:US
Practice Address - Phone:571-577-0063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-19
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide