Provider Demographics
NPI:1114540531
Name:MARCIA, JERMAN
Entity Type:Individual
Prefix:
First Name:JERMAN
Middle Name:
Last Name:MARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 RITTENHOUSE ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1945
Mailing Address - Country:US
Mailing Address - Phone:202-845-3343
Mailing Address - Fax:
Practice Address - Street 1:3322 14TH ST NW APT 315
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2365
Practice Address - Country:US
Practice Address - Phone:571-494-3319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant