Provider Demographics
NPI:1134700925
Name:KITTRELL, JANAY
Entity Type:Individual
Prefix:MS
First Name:JANAY
Middle Name:
Last Name:KITTRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1255 FARADAY PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2815
Mailing Address - Country:US
Mailing Address - Phone:202-239-9050
Mailing Address - Fax:
Practice Address - Street 1:150 Q ST NE # BE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2366
Practice Address - Country:US
Practice Address - Phone:202-460-9818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant